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Individual

RANDI DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 646-8000
Mailing address
17800 US HIGHWAY 18, APPLE VALLEY, CA 92307-1221
(760) 646-8000

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
224Z00000X
Occupational Therapy Assistant
Primary
6810
CA

Other

Enumeration date
02/22/2021
Last updated
04/10/2026
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