Healthcare Provider Details

I. General information

NPI: 1659824530
Provider Name (Legal Business Name): CHRISTIAN DONOVAN DOWNEY AMFT, CADCIII-CS(CA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARLENA DIANA MALLORY CATCII, CCS

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W CIVIC CENTER DR # 700
SANTA ANA CA
92701-4515
US

IV. Provider business mailing address

401 W CIVIC CENTER DR # 704
SANTA ANA CA
92701-4515
US

V. Phone/Fax

Practice location:
  • Phone: 714-480-6660
  • Fax:
Mailing address:
  • Phone: 714-480-6660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number128579
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: