Active NPI
Dominique Michelle Gillyard, DNP
- Family Nurse Practitioner
- Downey, CA
National Provider Identifier
1710791082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95031870
- Practice address
- 11938 Paramount Blvd
Downey, CA 90242-2306 - Phone
- (657) 391-3713
- NPI assigned
- Feb 5, 2025
- Last updated
- Feb 5, 2025
- 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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 95031870 | CA | MD | Family 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.