Individual provider Active NPI

Clariza L Aguillon-Doms, NP

  • Nurse Practitioner
  • Woodland, CA
National Provider Identifier
1174836993
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP19828 Issued in CA
Practice address
632 W Gibson Rd
Woodland, CA 95695-5169
Phone
(530) 669-3261
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP19828 CA Primary

Addresses

Primary practice location

632 W Gibson Rd
Woodland, CA 95695-5169

Mailing address

632 W Gibson Rd
Woodland, CA 95695-5169
Phone (530) 669-3261

Other identifiers 1

IdentifierTypeStateIssuer
FK624ZOtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111003000172 CA Practitioner - Nurse Practitioner 5395917058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

632 W Gibson Rd
Woodland, CA 95695-5169
Phone (530) 668-2600

Hospital & facility affiliations

  • Woodland Memorial Hospital Hospital, Woodland, CA, CCN 050127

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP19828CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 20, 2011 Accepting new patients
CHW Medical Foundation CurrentSince Aug 20, 2011 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Mar 16, 2021 Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

632 W Gibson Rd
Woodland, CA 95695
Phone (530) 666-1631

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1174836993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955169",
            "telephone_number": "530-669-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955169",
            "telephone_number": "530-669-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILLON-DOMS",
        "first_name": "CLARIZA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP19828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "FK624Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.