Dominique Nicole Miranda, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

53473 Issued in CA

Practice address

2437 Fenton St Ste B
Chula Vista, CA 91914-3517

Phone

(619) 361-5409

NPI assigned

Apr 3, 2025

Last updated

Apr 3, 2025By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1376347609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 ROMEGA CT",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2437 FENTON ST STE B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143517",
            "telephone_number": "619-361-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "DOMINIQUE",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "53473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.url",
            "affiliation": "N",
            "address_1": "2437 Fenton St Ste B",
            "city": "Chula Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919143517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabriella Miranda Miranda, FNP
• Andrea Miranda
• Angela Sophia Miranda
• Brianna Nicole Miranda
• Celia Miranda
• Jocelyn K Miranda
• Jose Raul Mireles - Guzman
• Genesis Sarahi Mireles
• Jaime Mireles, B.A.
• Bashar Mirza, M.D.

• Physical Therapy Assistant in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.