Individual
ANAYELI DOMINGUEZ PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 W F ST STE 101, ONTARIO, CA 91762-3201
(909) 986-4550
Mailing address
1067 E HOLT BLVD TRLR 38, ONTARIO, CA 91761-1926
(909) 354-1488
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/16/2024
Last updated
12/27/2024
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