Active NPI
Lolita M. Domingue, LMFT
- Marriage & Family Therapist
- Upland, CA
National Provider Identifier
1407108483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC33746
- Practice address
- 1150 N Mountain Ave Ste 203
Upland, CA 91786-3668 - Phone
- (909) 982-5171
- Fax
- (909) 982-5171
- NPI assigned
- Oct 15, 2012
- Last updated
- May 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC33746 | CA | Primary |
Addresses
Primary practice location
1150 N Mountain Ave Ste 203
Upland, CA 91786-3668
Mailing address
1150 N Mountain Ave Ste 203
Upland, CA 91786-3668
Phone (909) 982-5171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC33746 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399248000000",
"number": "1407108483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 N MOUNTAIN AVE STE 203",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863668",
"telephone_number": "909-982-5171",
"fax_number": "909-982-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 N MOUNTAIN AVE STE 203",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863668",
"telephone_number": "909-982-5171",
"fax_number": "909-982-5171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUE",
"first_name": "LOLITA",
"middle_name": "M.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-15",
"last_updated": "2014-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC33746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.