Dominique Sanders Nursing Corporation

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

DOMINIQUE SANDERS NURSING CORPORATION

Practice address

9431 Haven Ave Ste 100
Rancho Cucamonga, CA 91730-5879

Phone

(725) 234-2215

Fax

(281) 954-0056

NPI assigned

Oct 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dominique Sanders

Title

Pmhnp-BC

Phone

(725) 234-2215

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1316580665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305879",
            "telephone_number": "725-234-2215",
            "fax_number": "281-954-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 HAVEN AVE STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305879",
            "telephone_number": "725-234-2215",
            "fax_number": "281-954-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIQUE SANDERS NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2021-09-14",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "725-234-2215"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.