Most Relevant Information
Provider Data
| NPI Number: | 1003679259 |
| Provider Name: | KAITLYN DOMINGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/31/2024 |
| Last Updated: | 01/31/2024 |
Provider Practice Location
801 CORPORATE CENTER DR STE 210
POMONA
CA
917682627
Practice Location Phone/Fax
| Phone: | 9096343974 |
| Fax: |
Provider Mailing Location
2246 S BON VIEW AVE
ONTARIO
CA
917615802
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |