Individual
ALICIA ERIKA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
303 W LINCOLN AVE STE 105, ANAHEIM, CA 92805-2928
(714) 922-2490
Mailing address
1800 N BRISTOL ST # C-293, SANTA ANA, CA 92706-3336
(949) 245-2314
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
ASW63368
CA
1041C0700X
Clinical Social Worker
Primary
LCSW83413
CA
Other
Enumeration date
10/31/2014
Last updated
06/20/2024
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