Individual provider Active NPI

Eileen Marie Domalaog, CCC-SLP

  • Speech-Language Pathologist
  • Salinas, CA
National Provider Identifier
1083208045
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
25866 Issued in CA
Practice address
535 E Romie LN Ste 1
Salinas, CA 93901-4026
Phone
(831) 998-7554
Fax
(831) 273-1796
NPI assigned
Feb 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 25866 CA Primary

Addresses

Primary practice location

535 E Romie LN Ste 1
Salinas, CA 93901-4026

Mailing address

535 E Romie LN Ste 1
Salinas, CA 93901-4026
Phone (831) 998-7554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210517000459 CA Practitioner - Qualified Speech Language Pathologist 1355750654 Reassigns benefits to 1 organization
Practice locations: Salinas, CA

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

535 E Romie LN
Suite 1
Salinas, CA 93901-4026
Phone (831) 998-7554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Salinas Valley Speech Pathology Speech-Language Pathologist CurrentSince Feb 1, 2022 Accepting new patients

Locations

47 San Miguel Ave
Ste 3
Salinas, CA 93901
Phone (831) 210-8704

535 E Romie Ln
Ste 1
Salinas, CA 93901
Phone (831) 422-7195

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1083208045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 E ROMIE LN STE 1",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014026",
            "telephone_number": "831-998-7554",
            "fax_number": "831-273-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 E ROMIE LN STE 1",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014026",
            "telephone_number": "831-998-7554",
            "fax_number": "831-273-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMALAOG",
        "first_name": "EILEEN",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "25866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.