Dominique Blanchette, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY11190 Issued in FL

Practice address

10590 City Center Blvd Apt 204
Pembroke Pines, FL 33025-4656

Phone

(916) 730-1538

NPI assigned

Nov 8, 2021

Last updated

Nov 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1154086890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 CITY CENTER BLVD APT 204",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 CITY CENTER BLVD APT 204",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254656",
            "telephone_number": "916-730-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHETTE",
        "first_name": "DOMINIQUE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.