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NPI Code Detail

MEDICARE: DANYA SAMANTHA DOMINGUEZ DE ANDA

MEDICARE: DANYA SAMANTHA 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
1106H00000XMarriage & Family TherapistAMFT153464CA

General Provider Information

NPI Number : 1104689827
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANYA SAMANTHA DOMINGUEZ DE ANDA
Provider Business Mailing Address
First Line : 3435 WILSHIRE BLVD.
Second Line : SUITE# 1840
City : LOS ANGELES
State : CA
Zip : 90010-2004
Country : US
Telephone Number : 209-681-4252
Fax Number :
Provider Business Practice Location Address
First Line : 3435 WILSHIRE BLVD.
Second Line : SUITE# 1840
City : LOS ANGELES
State : CA
Zip : 90010-2004
Country : US
Telephone Number : 209-681-4252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 10/28/2025

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Directions to “ DANYA SAMANTHA DOMINGUEZ DE ANDA ” Practice Location

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