Provider Demographics
NPI:1962381475
Name:DONATO, PRINCESS MARILYN LAGOS (PTA)
Entity type:Individual
Prefix:MRS
First Name:PRINCESS MARILYN
Middle Name:LAGOS
Last Name:DONATO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:900 SUSAN ST APT 21
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-1064
Mailing Address - Country:US
Mailing Address - Phone:661-229-0088
Mailing Address - Fax:
Practice Address - Street 1:1205 GARCES HWY STE 208
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3658
Practice Address - Country:US
Practice Address - Phone:661-642-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51692225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant