Provider Demographics
NPI:1982741062
Name:ST.CLAIR, DONNA ANDERSON (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:ANDERSON
Last Name:ST.CLAIR
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3549 CARLETON STREET
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2526
Mailing Address - Country:US
Mailing Address - Phone:619-223-1802
Mailing Address - Fax:619-223-1802
Practice Address - Street 1:4305 GESNER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6639
Practice Address - Country:US
Practice Address - Phone:858-494-9597
Practice Address - Fax:619-223-1802
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health