Dominic Walter Ysidron, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6868 Issued in NC

Practice address

2700 Benson Rd
Garner, NC 27529-9059

Phone

(984) 202-7700

NPI assigned

Mar 30, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Durham Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Garner, NC
  • NPI 1447134234
  NPD
• Ohio University Psychology and Social Work Clinic

  • Clinical Psychologist
  • Athens, OH
  • NPI 1972723971
  NPD (past)

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

{
    "created_epoch": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1851852891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BENSON RD",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275299059",
            "telephone_number": "984-202-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YSIDRON",
        "first_name": "DOMINIC",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-30",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "6868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Wright, M.ED., CCC-SLP
• Nia Wright
• Robin Mullins Wulf, PHARMD
• Jeremy Yates, DO
• Brittany Gayle Yearwood, MSW
• Hussein A Zarqa
• Laura Zohn
• Jason Zuch, MS CCC-SLP

• Clinical Psychologist in Garner, NC
• Providers in Garner, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.