Roberto Dominguez, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

77649 Issued in CA

Practice address

1774 Zonal Ave BLDG C
Los Angeles, CA 90033-1064

Phone

(310) 221-6336

NPI assigned

Oct 22, 2007

Last updated

Sep 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: robert.dominguez.p3@direct.parktreechc.nextgenshare.com

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1770772121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 ZONAL AVE BLDG C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331064",
            "telephone_number": "310-221-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 ZONAL AVE BLDG C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331064",
            "telephone_number": "310-221-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ROBERTO",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luz Maria Dominguez
• Maria Dominguez, LMFT
• Megan Rose Dominguez, OTR/L
• Rachel Dominguez
• Racquel Dominguez
• Rose Dominguez, CADAC
• Rosie V Dominguez, LCSW
• Stefie C Dominguez, AMFT
• Steve Dominguez
• Dominion Alcohol & Drug Program

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.