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General NPI Number Information
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NPI Number | 1497909154
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Entity Type | Individual
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Provider Name | CHARLENE DICHOSO DOMINGO-YAMAMOTO L.AC., M.AC.O.M.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 1750 KALAKAUA AVE SUITE 808
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City | HONOLULU
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State | HI
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Zip | 96826-3766
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Country | US
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Telephone | 808-589-6937
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Fax |
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Provider Business Mailing Address
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Address Line | 9159 W DESERT INN RD APT J104
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City | LAS VEGAS
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State | NV
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Zip | 89117-6372
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Country | US
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Telephone | 808-554-3257
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT2888
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License Number State | NV
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