Individual provider Active NPI

Daniel Ritua Domaguin, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1578895488
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 64747 Issued in CA
Practice address
10265 Rockingham Dr # 100-4013
Sacramento, CA 95827-2523
Phone
(916) 229-6461
NPI assigned
Feb 2, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 64747 CA Primary

Addresses

Primary practice location

10265 Rockingham Dr # 100-4013
Sacramento, CA 95827-2523

Mailing address

10265 Rockingham Dr # 100-4013
Sacramento, CA 95827-2523
Phone (916) 229-6461

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
LCS 64747CAMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: daniel.domaguin.p1@direct.scihp.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1578895488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10265 ROCKINGHAM DR # 100-4013",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272523",
            "telephone_number": "916-229-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10265 ROCKINGHAM DR # 100-4013",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272523",
            "telephone_number": "916-229-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAGUIN",
        "first_name": "DANIEL",
        "middle_name": "RITUA",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 64747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.