Provider Demographics
NPI:1386362374
Name:DONATI, BETH MICHELLE (BCBA)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:MICHELLE
Last Name:DONATI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:MICHELLE
Other - Last Name:MCGOWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2393 JANIN PL
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-9401
Mailing Address - Country:US
Mailing Address - Phone:805-350-4407
Mailing Address - Fax:
Practice Address - Street 1:2393 JANIN PL
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-9401
Practice Address - Country:US
Practice Address - Phone:805-350-4407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-53897103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst