John C Dolores, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.022226 Issued in IL

Practice address

6905 Via Locanda Ave
Las Vegas, NV 89131-0113

Phone

(916) 385-4849

NPI assigned

Apr 6, 2011

Last updated

Aug 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IL

  Medicare reassignment NPD
• Ladder Treatment Services Management LLC

  dba Exalted Treatment Centers

  • Adult Mental Health Clinic/Center
  • Cameron Park, CA
  • NPI 1508683533
  NPD Authorized official
• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960

  IL

  Medicare reassignment
• Authentic Psychological Services Inc

  • Psychologist
  • Los Angeles, CA
  • NPI 1295615045
  Authorized official Same address or phone
• New Journey Living, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Harriman, TN
  • NPI 1841761574
  Authorized official Same address or phone
• SCMD Medical PC

  • Clinical Social Worker
  • Richmond, VA
  • NPI 1437016805
  Authorized official Same address or phone

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1417246869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6905 VIA LOCANDA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891310113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 VIA LOCANDA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891310113",
            "telephone_number": "916-385-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLORES",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.022226",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.022226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devae Lashaun Dolley
• Erica Dollman
• Aiza M Dollopac
• Konny Lourdes Dolomandin
• Charlemagne Serena Dolor, RN
• Luke Dolores
• Eathan Dolson
• Matthew Domanguera, RN
• Kristina Halina Domanski, M.D
• Thomas Mark Dombroski, LCSW

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.