Provider Demographics
NPI:1841544038
Name:FRANK, DONELL JR (MFT)
Entity type:Individual
Prefix:MR
First Name:DONELL
Middle Name:
Last Name:FRANK
Suffix:JR
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 E PALMDALE BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4750
Mailing Address - Country:US
Mailing Address - Phone:213-521-9089
Mailing Address - Fax:
Practice Address - Street 1:1050 E PALMDALE BLVD STE 211
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4750
Practice Address - Country:US
Practice Address - Phone:213-521-9089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT112516101YM0800X
CA112516106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA112516Medicaid