Provider Demographics
NPI:1740328525
Name:DI DONNA, LUCA (PHD)
Entity type:Individual
Prefix:
First Name:LUCA
Middle Name:
Last Name:DI DONNA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 LAUREL ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1951
Mailing Address - Country:US
Mailing Address - Phone:415-346-0722
Mailing Address - Fax:
Practice Address - Street 1:399 LAUREL ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1951
Practice Address - Country:US
Practice Address - Phone:415-346-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8425103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL84250Medicare ID - Type UnspecifiedPSYCHOLOGIST