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NPI Profile for SUSAN DOMINGUEZ in BERKELEY, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intellectual & Developmental Disabilities |
103TM1800X | 62 | Psychologist, Clinical |
| NPI Number | 1477709483 |
|
| Status | Active | |
| Credentials | PSY24264 | |
| Entity | Individual | |
| Enumeration date | 08/09/2008 | |
| Last updated | 02/04/2026 - About 4 months ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SUSAN DOMINGUEZ
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SUSAN DOMINGUEZ, PSY24264