Tina L. R. Dominguez, PA-C, MMS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21463 Issued in CA

Practice address

2305 Camino Ramon Ste 225
San Ramon, CA 94583-1394

Phone

(253) 471-4509

Fax

(925) 347-1454

NPI assigned

Feb 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tdominguez131126@direct-ucsfmedicalcenter.org

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.

• Fortra Medical Group of California, PC

  • Allergy Physician
  • Redwood City, CA
  • NPI 1326522566
  NPD
• Pediatric Wellness Group

  • Pediatrics Physician
  • Redwood City, CA
  • NPI 1679871057
  NPD (past)
• Silicon Valley Allergy and Asthma Inc.

  • Allergy & Immunology Physician
  • Mountain View, CA
  • NPI 1518255082
  NPD (past)
• Theodore J. Chu, MD, Allergy and Asthma, Inc.

  • Allergy Physician
  • San Jose, CA
  • NPI 1225520547
  NPD (past)
• UCSF Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1922124866
  NPD (past)

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1922305671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 OLYMPIC AVE",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945446528",
            "telephone_number": "650-766-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CAMINO RAMON STE 225",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831394",
            "telephone_number": "253-471-4509",
            "fax_number": "925-347-1454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 N Wiget Ln Ste 210",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945982452",
            "country_code": "US",
            "telephone_number": "925-935-6252",
            "fax_number": "925-347-1454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "TINA",
        "middle_name": "L. R.",
        "credential": "PA-C, MMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-15",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "PA21463",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Dodd, M.A., CCC-SLP
• Sabina Dodoo
• Niki Dolatshahi
• Raul Domingo
• Daniel E Dominguez, D.C.
• Robert Marc Donatiello, MD
• Maria Dondero, PHARM.D.
• Tara Kay Donham
• Donor Network West
• Katelyn Marie Donovan Lopata

• Physician Assistant in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.