Healthcare Provider Details

I. General information

NPI: 1750587986
Provider Name (Legal Business Name): DONNA JEAN CROWELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 E. CHAPMAN AVE
ORANGE CA
92866
US

IV. Provider business mailing address

1440 E. CHAPMAN AVE
ORANGE CA
92866
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-2880
  • Fax: 714-771-2693
Mailing address:
  • Phone: 714-771-2880
  • Fax: 714-771-2693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS #13894
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: