Individual
YASMIN DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8919 CALIFORNIA AVE, SOUTH GATE, CA 90280-3013
(323) 487-5126
Mailing address
8919 CALIFORNIA AVE, SOUTH GATE, CA 90280-3013
(323) 487-5126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
09/21/2024
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