Mark Jeffrey Vigil Dombeck, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY25695 Issued in CA

Practice address

1402 Park St Ste G
Alameda, CA 94501-4562

Phone

(510) 900-5123

Fax

(888) 974-4218

NPI assigned

May 1, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mark Jeffrey Dombeck Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychtools Psychology Group P.C.

  • Clinical Psychologist
  • Alameda, CA
  • NPI 1013332725
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511049600000",
    "number": "1689019812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 PARK ST STE G",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014562",
            "telephone_number": "510-900-5123",
            "fax_number": "888-974-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 PARK ST STE G",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014562",
            "telephone_number": "510-900-5123",
            "fax_number": "888-974-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL DOMBECK",
        "first_name": "MARK",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2017-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY25695",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY25695",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "DOMBECK",
            "middle_name": "JEFFREY",
            "credential": "PH.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veris Eastbay Homecare
• Diana VI, PHARM.D.
• Tyler John Vian
• Nicholas Vibar, PTA
• Ronwald Vicencio, RD
• Sara Marie Vigil
• Krishma Vij
• Dilini Nelum Vilathgamuwa
• Kin (Katrina) Isabella Gabrielle Villacarlos
• Lynette Codamon Villadelgado, P.T.

• Clinical Psychologist in Alameda, CA
• Providers in Alameda, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.