Individual provider Active NPI

Jack L. Doman Jr., LMFT

  • Marriage & Family Therapist
  • Thousand Oaks, CA
National Provider Identifier
1508067299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC38923 Issued in CA
Practice address
550 Saint Charles Dr
Suite 101a
Thousand Oaks, CA 91360-3951
Phone
(805) 480-1167
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC38923 CA Primary

Addresses

Primary practice location

550 Saint Charles Dr
Suite 101a
Thousand Oaks, CA 91360-3951

Mailing address

362 Ridgemont CT
Newbury Park, CA 91320-4837
Phone (805) 480-1167

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

State licenses

LicenseStateTypeSpecialty
MFC38923CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508067299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 RIDGEMONT CT",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204837",
            "telephone_number": "805-480-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SAINT CHARLES DR",
            "address_2": "SUITE 101A",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603951",
            "telephone_number": "805-480-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAN",
        "first_name": "JACK",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC38923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.