Daniela Dominguez, PSYD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

29367 Issued in CA

Practice address

245 Kentucky St Ste E
Petaluma, CA 94952-2877

Phone

(415) 212-9064

NPI assigned

Oct 24, 2022

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• On the Margins Family Therapy & Psychological Services, Inc.

  dba On the Margins

  • Psychologist
  • Petaluma, CA
  • NPI 1043937790
  Medicare reassignment NPD Authorized official
• On the Margins, Inc.

  • Community Health Worker
  • Petaluma, CA
  • NPI 1649115171
  NPD Authorized official

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1720705460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MARINERO CIR",
            "city": "BELVEDERE TIBURON",
            "state": "CA",
            "postal_code": "949201627",
            "telephone_number": "415-212-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 KENTUCKY ST STE E",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522877",
            "telephone_number": "415-212-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "DANIELA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "29367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.onthemargins.us",
            "affiliation": "N",
            "address_1": "245 Kentucky St Ste E",
            "city": "Petaluma",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949522877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steffanie Dolch
• Dawn Michelle Dolcini, LMFT
• Reilly Lane Dolcini, DC
• Lisabel Dolne
• Matthew Domingos
• Debbie Ann Dominquez-Wiggins, BSC.
• David Dean Donaldson, D.C.
• Calvin Dong
• Stephen Donnellan
• Laurie M. Doolittle, MD

• Counseling Psychologist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Counseling Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.