Provider Demographics
NPI:1871340547
Name:DONEZ, MATTHEW ERNIE
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ERNIE
Last Name:DONEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 SANGO CT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7097
Mailing Address - Country:US
Mailing Address - Phone:510-453-0575
Mailing Address - Fax:
Practice Address - Street 1:355 SANGO CT
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7097
Practice Address - Country:US
Practice Address - Phone:510-453-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator