Individual
EDITH INEZ DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PSYCH CNS
Contact information
Practice address
550 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(213) 738-4945
Mailing address
550 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(213) 738-4945
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
164361
CA
Other
Enumeration date
06/28/2017
Last updated
07/21/2022
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