Healthcare Provider Details

I. General information

NPI: 1407923782
Provider Name (Legal Business Name): DONNA STAPP MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 E 17TH ST #119
SANTA ANA CA
92705-8627
US

IV. Provider business mailing address

1913 E 17TH ST #119
SANTA ANA CA
92705-8627
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-6720
  • Fax: 714-543-6730
Mailing address:
  • Phone: 714-543-6720
  • Fax: 714-543-6730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC23948
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMFC23948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: