Dominique Lariah Johnson

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1330 E Adams Park Dr
Covina, CA 91724-2923

Phone

(626) 428-4023

NPI assigned

Mar 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Domynyque Laryah Johnson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1518668185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 E ADAMS PARK DR",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 E ADAMS PARK DR",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242923",
            "telephone_number": "626-428-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOMINIQUE",
        "middle_name": "LARIAH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMYNYQUE",
            "last_name": "JOHNSON",
            "middle_name": "LARYAH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Bouz DO, Inc.
• John Khalaf DDS, Inc. (covina surgery center dental group)
• Blair R Johnson, PA
• Caitlin Johnson
• Coral Lynn Johnson, LPCC, PPS
• Eleanormae Johnson, OTR/L
• Eric Jason Johnson, B.A.
• Greta Francine Johnson, M.D.
• Natasha Nichol Johnson
• Renaldo N Johnson

• Athletic Trainer in Covina, CA
• Providers in Covina, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2024; 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.