MEDICARE: JOCELIN SABRINA DOMINGUEZ

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
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1255228029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELIN SABRINA DOMINGUEZ

Provider Business Mailing Address
First Line	:	PO BOX 73
Second Line	:
City	:	DAVENPORT
State	:	CA
Zip	:	95017-0073
Country	:	US
Telephone Number	:	831-227-7152
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 73
Second Line	:
City	:	DAVENPORT
State	:	CA
Zip	:	95017-0073
Country	:	US
Telephone Number	:	831-227-7152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

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Directions to “ JOCELIN SABRINA DOMINGUEZ ” Practice Location

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