Provider Demographics
NPI:1881735603
Name:OSTENDORF, DONALD E (MA)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:OSTENDORF
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 CONTINENTAL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1133
Mailing Address - Country:US
Mailing Address - Phone:530-241-5999
Mailing Address - Fax:530-241-6541
Practice Address - Street 1:1614 CONTINENTAL ST
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1133
Practice Address - Country:US
Practice Address - Phone:530-241-5999
Practice Address - Fax:530-241-6541
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30079106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist