Mliss M Doman, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

25598 Issued in CA

Practice address

16366 Ridge View Dr
Apple Valley, CA 92307-1243

Phone

(760) 900-1963

NPI assigned

Jul 31, 2023

Last updated

Jul 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evolving Pathways Psychology CorporationGroup PAC ID 6002212115, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

95

Improvement activities

40

Cost

76.74

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evolving Pathways Psychology Corporation

  • Clinical Psychologist
  • Hermosa Beach, CA
  • NPI 1194303446
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1013698042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12277 APPLE VALLEY RD # 133",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923081701",
            "telephone_number": "760-900-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16366 RIDGE VIEW DR",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071243",
            "telephone_number": "760-900-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAN",
        "first_name": "MLISS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "25598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaisa Lyn Dodge, PA
• Rebecca Ruth Dodge
• Emily Brianne Does, PA-C
• Melissa Doiron-Min, IMF
• Kaitlin Joy Dolinar, PHYSICIAN ASSISTANT
• Alva M Dominguez Sanchez
• Randi Dominguez
• Cody Donahue, PA-C
• Meredith Donaldson
• Dianna Jeanne Donofrio, MPT

• Psychologist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.