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NPI Code Detail

MEDICARE: DOMINIQUE LANDO

MEDICARE: DOMINIQUE LANDO
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 TherapistMFT44542CA

General Provider Information

NPI Number : 1447113840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE LANDO
Provider Business Mailing Address
First Line : 2915 MLK JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94703-2133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2915 MLK JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94703-2133
Country : US
Telephone Number : 510-882-3363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ DOMINIQUE LANDO ” Practice Location

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