Provider Demographics
NPI:1588869341
Name:ROYBAL, DONNA JUNE (MD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:JUNE
Last Name:ROYBAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2841
Mailing Address - Country:US
Mailing Address - Phone:707-258-8757
Mailing Address - Fax:
Practice Address - Street 1:7210 JOHNSTON RD
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-9466
Practice Address - Country:US
Practice Address - Phone:210-802-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP67152084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302333002OtherCSHCN
TX323333001Medicaid
TX323333001Medicaid