Provider Demographics
NPI:1588794366
Name:MATTHEWS, DONNA LEE
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LEE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 STILLMAN WAY
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540-2436
Mailing Address - Country:US
Mailing Address - Phone:916-505-3494
Mailing Address - Fax:
Practice Address - Street 1:270 N PINE ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4334
Practice Address - Country:US
Practice Address - Phone:916-463-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor