Sophia Aaliyah Dominguez
Behavior Technician in Stockton, CA. Individual provider (NPI-1).
NPI number1043045156
StatusActive
Last updated in NPPESSep 6, 2024
Details
- NPI
- 1043045156
- Entity type
- Individual (NPI-1)
- Name
- Sophia Aaliyah Dominguez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 6, 2024
- Certification date
- Sep 6, 2024
- Last updated
- Sep 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | CA | Yes |
Practice location
2291 W March Ln Ste C101Stockton, CA 95207-6669
Phone 916-729-3098
Mailing address
1313 Ensenada DrModesto, CA 95355-2313
Phone 669-292-7955
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