Individual
DIANDRIA ALIYSHA DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1234 EMPIRE ST, FAIRFIELD, CA 94533-5711
(210) 268-8887
Mailing address
2080 MORGAN CT, FAIRFIELD, CA 94534-7464
(210) 268-8887
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
91902
CA
104100000X
Social Worker
Primary
91902
CA
1041C0700X
Clinical Social Worker
117732
CA
Other
Enumeration date
09/18/2019
Last updated
08/30/2023
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