Active NPI
Dominic Marc Maldonado
- Community Health Worker
- Jurupa Valley, CA
National Provider Identifier
1407684384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3924 Riverview Dr
Jurupa Valley, CA 92509-6611 - Phone
- (951) 360-4175
- NPI assigned
- Jul 23, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3924 Riverview Dr
Jurupa Valley, CA 92509-6611
Mailing address
3924 Riverview Dr
Jurupa Valley, CA 92509-6611
Phone (951) 360-4175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jurupa Unified School District | Current | Accepting new patients | |
| Art Autism Related Therapy | Past | Accepting new patients |
Locations
3924 Riverview Dr
Riverside, CA 92509
Phone (951) 360-4175
Organizations & group practices 2
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.
-
- Local Education Agency (LEA)
- Jurupa Valley, CA
- NPI 1861037954
-
- Behavior Analyst
- Rancho Cucamonga, CA
- NPI 1114431392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775520000000",
"number": "1407684384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3924 RIVERVIEW DR",
"city": "JURUPA VALLEY",
"state": "CA",
"postal_code": "925096611",
"telephone_number": "951-360-4175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3924 RIVERVIEW DR",
"city": "JURUPA VALLEY",
"state": "CA",
"postal_code": "925096611",
"telephone_number": "951-360-4175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "DOMINIC",
"middle_name": "MARC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-23",
"last_updated": "2026-04-07",
"certification_date": "2026-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jurupa Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.