Healthcare Provider Details

I. General information

NPI: 1366369001
Provider Name (Legal Business Name): NATALIE P DOMINGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W KIMBERLY AVE STE 125
PLACENTIA CA
92870-6346
US

IV. Provider business mailing address

18735 ALDERBURY DR
ROWLAND HEIGHTS CA
91748-4804
US

V. Phone/Fax

Practice location:
  • Phone: 714-203-6595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: