Provider Demographics
NPI:1952541799
Name:DOONAN, JOHN L (LMFT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:DOONAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CLEARWATER CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4994
Mailing Address - Country:US
Mailing Address - Phone:408-314-2618
Mailing Address - Fax:
Practice Address - Street 1:21580 STEVENS CREEK BLVD
Practice Address - Street 2:#112
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1244
Practice Address - Country:US
Practice Address - Phone:408-314-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT20000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist