Provider Demographics
NPI:1962193870
Name:DONATO, AILANA SARIA
Entity type:Individual
Prefix:
First Name:AILANA
Middle Name:SARIA
Last Name:DONATO
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 1:1940 E DEERE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5718
Mailing Address - Country:US
Mailing Address - Phone:714-403-9535
Mailing Address - Fax:
Practice Address - Street 1:1940 E DEERE AVE STE 100
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5718
Practice Address - Country:US
Practice Address - Phone:714-953-4455
Practice Address - Fax:714-542-2793
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2025-02-05
Deactivation Date:2023-06-13
Deactivation Code:
Reactivation Date:2023-06-29
Provider Licenses
StateLicense IDTaxonomies
CA18116101YM0800X
CA150976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health