Fernando Carlos Dominguez Jr., LPT

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT26056 Issued in CA

Practice address

300 Hillmot Ave
Ventura, CA 93003

Phone

(805) 652-6727

NPI assigned

Aug 14, 2007

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1700078607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HILLMONT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031651",
            "telephone_number": "805-652-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HILLMOT AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-652-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "FERNANDO",
        "middle_name": "CARLOS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT26056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert F Dodge, M.D.
• Ann Doherty, LCSW
• Abdullah Burkay Dokuyucu, RPH
• Desiree Domingo-Foraste, M.D.
• Diane Jennifer Dominguez
• Ivan Matthew Dominguez
• Taylor Ann Dominguez
• Jessica Lee Donahue
• Donaldson Chiropractic, Inc.
• Jake David Donaldson, M.D.

• Licensed Psychiatric Technician in Ventura, CA
• Providers in Ventura, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.