Provider Demographics
NPI:1992918734
Name:HUSON, DONNA JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:JEAN
Last Name:HUSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:PREBBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4605 BARRANCA PKWY
Mailing Address - Street 2:SUITE 101-F
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4767
Mailing Address - Country:US
Mailing Address - Phone:949-857-0984
Mailing Address - Fax:949-857-0984
Practice Address - Street 1:4605 BARRANCA PKWY
Practice Address - Street 2:SUITE 101-F
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4767
Practice Address - Country:US
Practice Address - Phone:949-857-0984
Practice Address - Fax:949-857-0984
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical