Provider Demographics
NPI:1154970150
Name:DOAN, MINDY (MFT, MA)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:MFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2028
Mailing Address - Country:US
Mailing Address - Phone:626-244-7542
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2028
Practice Address - Country:US
Practice Address - Phone:626-244-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2024-04-01
Deactivation Date:2023-07-12
Deactivation Code:
Reactivation Date:2024-02-27
Provider Licenses
StateLicense IDTaxonomies
CA132962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist