Provider Demographics
NPI:1902907884
Name:MINOR, DONNA M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:MINOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18299 LAUREL VIEW DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4029
Mailing Address - Country:US
Mailing Address - Phone:714-970-7237
Mailing Address - Fax:
Practice Address - Street 1:18200 YORBA LINDA BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4056
Practice Address - Country:US
Practice Address - Phone:714-970-7237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS208691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW20869Medicare ID - Type Unspecified