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NPI Code Detail

MEDICARE: RAIZA ALEJANDRA DOMINGUEZ DE ANDA

MEDICARE:   RAIZA ALEJANDRA DOMINGUEZ DE ANDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker103635CA

General Provider Information

NPI Number : 1164195160
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAIZA ALEJANDRA DOMINGUEZ DE ANDA
Provider Business Mailing Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2021
Last Update Date : 04/07/2026

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Directions to “ RAIZA ALEJANDRA DOMINGUEZ DE ANDA ” Practice Location

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