MEDICARE: DONIELLE COHEN LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	117892	CA

General Provider Information

NPI Number	:	1831470731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONIELLE COHEN LMFT

Provider Business Mailing Address
First Line	:	PO BOX 1903
Second Line	:
City	:	POWAY
State	:	CA
Zip	:	92074-1903
Country	:	US
Telephone Number	:	760-452-8447
Fax Number	:	855-782-1209

Provider Business Practice Location Address
First Line	:	9820 WILLOW CREEK RD STE 245
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92131-1116
Country	:	US
Telephone Number	:	760-452-8447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	09/13/2024

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