Individual
DR. ANN MARIE DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
310 JAMES WAY STE 110, PISMO BEACH, CA 93449-2877
(805) 295-0387
Mailing address
PO BOX 3421, SHELL BEACH, CA 93448-3421
(805) 796-9059
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY11715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY117150
—
CA
Enumeration date
08/21/2006
Last updated
03/28/2019
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