Provider Demographics
NPI:1326919325
Name:DOMINGO, ALVINA ANNE
Entity type:Individual
Prefix:
First Name:ALVINA
Middle Name:ANNE
Last Name:DOMINGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 S EASTERN AVE
Mailing Address - Street 2:3175 S EASTERN AVE
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3308
Mailing Address - Country:US
Mailing Address - Phone:702-320-5222
Mailing Address - Fax:
Practice Address - Street 1:3175 S EASTERN AVE
Practice Address - Street 2:3175 S EASTERN AVE
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3308
Practice Address - Country:US
Practice Address - Phone:702-320-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant