Individual provider Active NPI

Danielle Noret Dominguez

  • Marriage & Family Therapist
  • Escondido, CA
National Provider Identifier
1477855583
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
68767 Issued in CA
Practice address
17701 San Pasqual Valley Rd
Escondido, CA 92025-5301
Phone
(760) 741-4300
NPI assigned
Nov 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 68767 CA Primary

Addresses

Primary practice location

17701 San Pasqual Valley Rd
Escondido, CA 92025-5301

Mailing address

17701 San Pasqual Valley Rd
Escondido, CA 92025-5301
Phone (760) 741-4300

Other names 1

  • Danielle Dominuez Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516001361 ID Practitioner - Marriage and Family Therapist 2062853443 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68767CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benewah Medical Center CurrentSince Mar 20, 2024 Accepting new patients

Locations

427 12th St
Plummer, ID 83851
Phone (208) 686-5081

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1477855583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17701 SAN PASQUAL VALLEY RD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920255301",
            "telephone_number": "760-741-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17701 SAN PASQUAL VALLEY RD",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920255301",
            "telephone_number": "760-741-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "DANIELLE",
        "middle_name": "NORET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-22",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "68767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "DOMINUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.