Individual
AMBER NICOLE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401
(805) 781-4746
Mailing address
759 ANGUS ST, PASO ROBLES, CA 93446-4629
(805) 859-4498
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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