Provider Demographics
NPI:1215263439
Name:DOHRENWEND, DONICA (PHD)
Entity type:Individual
Prefix:
First Name:DONICA
Middle Name:
Last Name:DOHRENWEND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 OBERLIN DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3703
Mailing Address - Country:US
Mailing Address - Phone:858-877-0314
Mailing Address - Fax:
Practice Address - Street 1:5830 OBERLIN DR
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3703
Practice Address - Country:US
Practice Address - Phone:858-877-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 27969103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist