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Individual

DOMINIQUE CHURNETSKI-HAYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
25 N 14TH ST, SAN JOSE, CA 95112-6204
(510) 696-5810
Mailing address
25 N 14TH ST, SAN JOSE, CA 95112-6204
(510) 696-5810

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10Y00000X
CA

Other

Enumeration date
04/13/2022
Last updated
04/13/2022
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