Individual
MRS. SUSAN DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY24264
Contact information
Practice address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 601-0203
(510) 601-4002
Mailing address
6010 HIGHWAY 9 STE 7, FELTON, CA 95018-9535
(831) 515-6817
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
PSY24264
CA
Other
Enumeration date
08/09/2008
Last updated
02/04/2026
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