Provider Demographics
NPI:1790940120
Name:REMAKER, DOMINIQUE NICOLE (PHD)
Entity type:Individual
Prefix:DR
First Name:DOMINIQUE
Middle Name:NICOLE
Last Name:REMAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 ALAMO DR # 1097
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6344
Mailing Address - Country:US
Mailing Address - Phone:707-875-5223
Mailing Address - Fax:
Practice Address - Street 1:3069 ALAMO DR # 1097
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6344
Practice Address - Country:US
Practice Address - Phone:707-875-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31925103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical