Provider Demographics
NPI:1528114741
Name:DONOHUE, KATE TERESA (PHD)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:TERESA
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19201 NOYO ACRES DR
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:CA
Mailing Address - Zip Code:95437-8240
Mailing Address - Country:US
Mailing Address - Phone:415-695-1464
Mailing Address - Fax:415-695-1464
Practice Address - Street 1:19201 NOYO ACRES DR
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:CA
Practice Address - Zip Code:95437
Practice Address - Country:US
Practice Address - Phone:415-695-1464
Practice Address - Fax:415-695-1464
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9745174400000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No174400000XOther Service ProvidersSpecialist