Provider Demographics
NPI:1679294524
Name:HYPOLITE, DOMINIQUE VALENZUELA (LCSW)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:VALENZUELA
Last Name:HYPOLITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DOMINIQUE
Other - Middle Name:JENNIFER
Other - Last Name:VALENZUELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1860 HOWE AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-1098
Mailing Address - Country:US
Mailing Address - Phone:916-454-2345
Mailing Address - Fax:
Practice Address - Street 1:4815 WATT AVE
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-5108
Practice Address - Country:US
Practice Address - Phone:916-454-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1261891041C0700X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical