Active NPI
Jessica Dominguez
- Social Worker
- El Paso, TX
National Provider Identifier
1679396790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 109598
- Practice address
- 8500 Boeing Dr
El Paso, TX 79925-1224 - Phone
- (915) 599-6600
- NPI assigned
- Nov 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 109598 | TX | Primary |
Addresses
Primary practice location
8500 Boeing Dr
El Paso, TX 79925-1224
Mailing address
141 Johnny Telles
Clint, TX 79836
Phone (915) 328-8491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109598 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1679396790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 JOHNNY TELLES",
"city": "CLINT",
"state": "TX",
"postal_code": "79836",
"telephone_number": "915-328-8491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 BOEING DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799251224",
"telephone_number": "915-599-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMINGUEZ",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-06",
"last_updated": "2024-11-06",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "109598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.