Individual
DOMENIQUE HERRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
470 E 3RD ST STE C, LOS ANGELES, CA 90013-1630
(213) 620-5712
Mailing address
470 E 3RD ST STE C, LOS ANGELES, CA 90013-1630
(213) 620-5712
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12099
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
15583
CA
Other
Enumeration date
07/19/2021
Last updated
06/12/2024
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