Dominique Anne Marie Fragoso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12601 Issued in CA

Practice address

215 W Madison Ave
El Cajon, CA 92020-3405

Phone

(619) 401-6236

NPI assigned

Apr 23, 2019

Last updated

Apr 23, 2019By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1518521830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 REDBUD RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919106644",
            "telephone_number": "619-977-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203405",
            "telephone_number": "619-401-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGOSO",
        "first_name": "DOMINIQUE",
        "middle_name": "ANNE MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "12601",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "CA",
            "license": "12601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Foster, PA-C
• Kaydalyn Fowler
• Robert Fowler
• Maria R Fowlks, M.A.
• Andrew Fox
• Emily Fragoso
• James Francisco
• James Frank
• Mariah Franke
• Cori Earline Franklin

• Clinical Social Worker in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.

Verify at the official NPI Registry.