Provider Demographics
NPI:1740348564
Name:DOMINGUE, SAUNDRA YVETTE (MHCM)
Entity type:Individual
Prefix:MS
First Name:SAUNDRA
Middle Name:YVETTE
Last Name:DOMINGUE
Suffix:
Gender:F
Credentials:MHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 12TH ST
Mailing Address - Street 2:200
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1297
Mailing Address - Country:US
Mailing Address - Phone:415-321-3156
Mailing Address - Fax:415-554-1914
Practice Address - Street 1:68 12TH ST
Practice Address - Street 2:200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1297
Practice Address - Country:US
Practice Address - Phone:415-321-3156
Practice Address - Fax:415-554-1914
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA38BG3OtherMEDICAL