Individual provider Active NPI

Dominique Fluker

  • Psychiatric/Mental Health Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1962988279
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95038965 Issued in CA
Practice address
5225 Canyon Crest Dr
Riverside, CA 92507-6301
Phone
(951) 248-8675
NPI assigned
Jul 19, 2018
Last updated
May 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95038965 CA Primary
Registered Nurse 163W00000X 95231418 CA
Licensed Vocational Nurse 164X00000X 258994 CA

Addresses

Primary practice location

5225 Canyon Crest Dr
Riverside, CA 92507-6301

Mailing address

5225 Canyon Crest Dr
Riverside, CA 92507-6301
Phone (951) 248-8675

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
95231418CAMDRegistered Nurse
258994CAMDLicensed Vocational Nurse
95038965CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1962988279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 CANYON CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076301",
            "telephone_number": "951-248-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CANYON CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076301",
            "telephone_number": "951-248-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUKER",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95038965",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95231418",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "258994",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.