Individual provider Active NPI

Domenica Diaz Barrientos

  • Marriage & Family Therapist
  • San Pedro, CA
National Provider Identifier
1861262032
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT139691 Issued in CA
Practice address
222 W 6TH St Ste 230
San Pedro, CA 90731-3332
Phone
(310) 833-3135
Fax
(310) 707-2877
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT139691 CA Primary

Addresses

Primary practice location

222 W 6TH St Ste 230
San Pedro, CA 90731-3332

Mailing address

1301 Pine Ave
Long Beach, CA 90813-3124
Phone (562) 595-1159

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

LicenseStateTypeSpecialty
AMFT139691CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Guidance Center PastSince Jun 16, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1861262032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133124",
            "telephone_number": "562-595-1159",
            "fax_number": "562-426-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 6TH ST STE 230",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313332",
            "telephone_number": "310-833-3135",
            "fax_number": "310-707-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ BARRIENTOS",
        "first_name": "DOMENICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT139691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.