Individual
DOMINIQUE BORISENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2130 STOCKTON BLVD # 300, SACRAMENTO, CA 95817-1337
(165) 202-4609
Mailing address
2130 STOCKTON BLVD STE 300, SACRAMENTO, CA 95817-1337
(916) 520-2460
(916) 520-2459
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95376518
CA
164X00000X
Licensed Vocational Nurse
698010
CA
Other
Enumeration date
07/02/2018
Last updated
03/25/2025
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