Dominique Connor
Individual provider Active NPI Behavior Technician · Alta Loma, CA
NPI 1750869608 · NPPES record last updated Aug 2, 2018
Key facts
- NPI
- 1750869608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 7157 Archibald Ave Apt 168
Alta Loma, CA 91701-5079 - Phone
- (909) 578-6448
- NPI assigned
- Aug 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | Yes |
Addresses
Primary practice location
7157 Archibald Ave Apt 168
Alta Loma, CA 91701-5079
Mailing address
7157 Archibald Ave Apt 168
Alta Loma, CA 91701-5079
Phone (909) 578-6448
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- L. Todd Cochran
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- Daniel Quesada David
- Michelle David
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- Garet S Davis
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All providers in Alta Loma, CA · Behavior Technician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.