Healthcare Provider Details

I. General information

NPI: 1669388062
Provider Name (Legal Business Name): KEATON DONIGER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S LUCERNE BLVD
LOS ANGELES CA
90020-4749
US

IV. Provider business mailing address

400 S LUCERNE BLVD
LOS ANGELES CA
90020-4749
US

V. Phone/Fax

Practice location:
  • Phone: 323-819-5551
  • Fax:
Mailing address:
  • Phone: 323-819-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KEATON DONIGER
Title or Position: PSYCHOTHERAPIST
Credential: LMFT 160250
Phone: 323-819-5551