Healthcare Provider Details

I. General information

NPI: 1538070735
Provider Name (Legal Business Name): DR. SABRINA DOMINGUEZ, PSYD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 W PALMETTO PARK RD STE 410
BOCA RATON FL
33486-3325
US

IV. Provider business mailing address

5811 NW 72ND WAY
PARKLAND FL
33067-1265
US

V. Phone/Fax

Practice location:
  • Phone: 954-228-5802
  • Fax:
Mailing address:
  • Phone: 954-895-2519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SABRINA DOMINGUEZ
Title or Position: CLINICAL PSYCHOLOGIST
Credential:
Phone: 954-228-5802