Basic Information
Provider Information
NPI: 1104989300
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DONADIO
FirstName: MARGO
MiddleName: L
NamePrefix: MRS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 158 GREENBANK AVE
Address2:  
City: OROVILLE
State: CA
PostalCode: 959666819
CountryCode: US
TelephoneNumber: 5305340235
FaxNumber:  
Practice Location
Address1: 2858 OLIVE HIGHWAY
Address2: SUITES A B & C
City: OROVILLE
State: CA
PostalCode: 95966
CountryCode: US
TelephoneNumber: 5305382158
FaxNumber: 5305337188
Other Information
ProviderEnumerationDate: 12/18/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0807X427133CAY Nursing Service ProvidersRegistered NursePsych/Mental Health, Child & Adolescent

No ID Information.


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