Individual
DOMINIQUE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, RN, MSN
Contact information
Practice address
9431 HAVEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-5879
(725) 234-2215
(281) 954-0056
Mailing address
9431 HAVEN AVE STE 100, RANCHO CUCAMONGA, CA 91730-5879
(725) 234-2215
(281) 954-0056
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
828301
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95011218
CA
Other
Enumeration date
06/13/2014
Last updated
09/16/2021
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