Provider Demographics
NPI:1063900652
Name:MUNOZ, DORIS ALICIA
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:ALICIA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DORIS
Other - Middle Name:ALICIA
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-4302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8700 WARNER AVE STE 100
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3209
Practice Address - Country:US
Practice Address - Phone:323-445-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-29
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst