Domanique Cody Forbes, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

19962 Issued in CA

Practice address

2560 N Texas St Ste J
Fairfield, CA 94533-1649

Phone

(707) 330-6949

Fax

(707) 425-2543

NPI assigned

May 2, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Childrens Therapy Works

  • Rehabilitation Clinic/Center
  • Fairfield, CA
  • NPI 1275781700
  NPD (past)

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1538724893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 LYON RD APT 227",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347984",
            "telephone_number": "423-677-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N TEXAS ST STE J",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945331649",
            "telephone_number": "707-330-6949",
            "fax_number": "707-425-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "DOMANIQUE",
        "middle_name": "CODY",
        "name_prefix": "Mr.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "19962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Foerst
• Elaine Fok, DDS
• Debbie A Folgheraiter
• Kathryn Elaine Fone, DPM
• Natasha Le'Cinda Fonteno
• Anita Claire Ford, DDS
• Daniel Ford, PHARMD
• Rachel Eileen Ford
• Sarah Addison Ford, RD
• Forensic Medical Group, Inc.

• Occupational Therapist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.