Individual provider Active NPI

Dominique Flores

  • Speech-Language Pathologist
  • San Francisco, CA
National Provider Identifier
1679979645
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
23829 Issued in CA
Practice address
505 Parnassus Ave
San Francisco, CA 94143
Phone
(415) 476-1000
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 23829 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143

Mailing address

2270 46TH Ave
San Francisco, CA 94116-1507
Phone (415) 321-0974

Other practice location 1

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-4759

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9679CAMDClinical Social Worker
23829CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1679979645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 46TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161507",
            "telephone_number": "415-321-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94143",
            "telephone_number": "415-476-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053043",
            "country_code": "US",
            "telephone_number": "951-353-4759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "23829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.