Individual provider Active NPI

Dominique Michelle Gillyard, DNP

  • Family Nurse Practitioner
  • Downey, CA
National Provider Identifier
1710791082
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95031870 Issued in CA
Practice address
11938 Paramount Blvd
Downey, CA 90242-2306
Phone
(657) 391-3713
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95031870 CA Primary

Addresses

Primary practice location

11938 Paramount Blvd
Downey, CA 90242-2306

Mailing address

4437 Casa Grande Cir Apt 376
Cypress, CA 90630-2582
Phone (657) 391-3713

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
95031870CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1710791082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 CASA GRANDE CIR APT 376",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906302582",
            "telephone_number": "657-391-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11938 PARAMOUNT BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902422306",
            "telephone_number": "657-391-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLYARD",
        "first_name": "DOMINIQUE",
        "middle_name": "MICHELLE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.