Individual
JENNIFER DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2101 MAGNOLIA AVE, LONG BEACH, CA 90806-4521
(562) 218-1868
(562) 591-0346
Mailing address
8407 S VERMONT AVE, LOS ANGELES, CA 90044-3423
(323) 971-1325
(323) 971-1365
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-KYBVEP
CA
Other
Enumeration date
02/01/2012
Last updated
04/08/2025
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