Active NPI
Erica Helena Domen
- Health & Wellness Coach
- Ceres, CA
National Provider Identifier
1740161470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- 1D6B4BAB63
- Practice address
- 2503 Lawrence St
Ceres, CA 95307-3301 - Phone
- (209) 556-1500
- NPI assigned
- Sep 9, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | 1D6B4BAB63 | CA | Primary |
Addresses
Primary practice location
2503 Lawrence St
Ceres, CA 95307-3301
Mailing address
755 Red Barn PL
Lathrop, CA 95330-8975
Phone (209) 556-1500
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 |
|---|---|---|---|
| 1D6B4BAB63 | CA | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757376000000",
"number": "1740161470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 RED BARN PL",
"city": "LATHROP",
"state": "CA",
"postal_code": "953308975",
"telephone_number": "209-556-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2503 LAWRENCE ST",
"city": "CERES",
"state": "CA",
"postal_code": "953073301",
"telephone_number": "209-556-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMEN",
"first_name": "ERICA",
"middle_name": "HELENA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-09",
"last_updated": "2025-09-09",
"certification_date": "2025-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "CA",
"license": "1D6B4BAB63",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ceres, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.