Basic Information
| Provider Information | |||||||||
| NPI: | 1881735603 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSTENDORF | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1614 CONTINENTAL ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960011133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302415999 | ||||||||
| FaxNumber: | 5302416541 | ||||||||
| Practice Location | |||||||||
| Address1: | 1614 CONTINENTAL ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960011133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302415999 | ||||||||
| FaxNumber: | 5302416541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC30079 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.