Tiffany Dominguez, BS, SLPA

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

4612 Issued in CA

Practice address

730 Sunrise Ave Ste 120
Roseville, CA 95661-4549

Phone

(408) 437-8864

NPI assigned

Oct 19, 2022

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

Bachelor of Science

State licenses

Practice roles

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.

• County of Santa Clara

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)
• Integrated Intervention for Children With Autism

  • Speech-Language Pathologist
  • San Jose, CA
  • NPI 1669725834
  NPD (past)

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1174249205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 BERN CT STE 130",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951121242",
            "telephone_number": "408-437-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SUNRISE AVE STE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614549",
            "telephone_number": "408-437-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "TIFFANY",
        "credential": "BS, SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "4612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debora Dawn Dolan
• Kathryn Dole
• Leila Dolgieva
• Rebecca Shantelle Domeier, AMFT
• Patricia Gwen Dominguez, SUDCC II
• Donald E. Clarke, D.D.S., Inc.
• Donald R. Peterson,II, M.D. Inc.
• Isabella S-M Donato
• Phuc Son Si Dong, DO
• Gail Lynn Donner

• Speech-Language Assistant in Roseville, CA
• Providers in Roseville, CA by specialty
• Speech-Language Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.