Provider Demographics
NPI:1104117787
Name:DONAHUE, KATHLEEN ERIN (LMFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ERIN
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3607
Mailing Address - Country:US
Mailing Address - Phone:619-501-3466
Mailing Address - Fax:619-550-4007
Practice Address - Street 1:2333 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 160
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3607
Practice Address - Country:US
Practice Address - Phone:619-501-3466
Practice Address - Fax:619-550-4007
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 52376106H00000X
CA53798106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist