ALODIA BANUELOS DOMINGO (NPI# 1043635162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043635162 |
| Entity Type | Individual |
| Full Name | ALODIA BANUELOS DOMINGO |
| Other Name | ALODIA BANUELOS |
| Credential | NP |
| Practice Address |
5700 W Olive Ave Ste 102 Glendale AZ 85302 |
| Mailing Address |
5700 W Olive Ave Ste 102 Glendale AZ 85302-3147 |
| Practice Telephone | 6237386062 |
| Practice Fax Number | 6023549462 |
| Mailing Telephone | 6237386062 |
| Mailing Fax Number | 6023549462 |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2019-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN135342 | AZ | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP5625 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7200 W Bell Rd Bldg B, Glendale, AZ 85308 | 6238503622 | |
| 9305 W Thomas Rd, Suite 400, Phoenix, AZ 850373328 | 6233228906 |
| Street Address |
5700 W OLIVE AVE STE 102 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881974731 | The Wellness and Prevention Center, LLC | Nurse Practitioner | 5700 W Olive Ave Ste 102, Glendale, AZ 85302-3147 | 2011-08-24 |
| 1497246482 | Arizona Essential Holistic Care | Family Medicine | 5700 W Olive Ave Ste 102, Glendale, AZ 85302 | 2018-05-24 |
| 1114450962 | Jodi Lyn Lay | Pain Medicine | 5700 W Olive Ave Ste 102, Glendale, AZ 85302-3147 | 2017-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736190 | Tyler Davis LLC | Psychologist | 8607 N 59th Ave Suite C-6, Glendale, AZ 85302 | 2020-10-05 |
| 1679098420 | Sidney M Kingery | Physical Therapist | 5810 W Peoria Ave, Glendale, AZ 85302 | 2017-08-12 |
| 1255877825 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 5651 W. Harmont Dr, Glendale, AZ 85302 | 2017-01-06 |
| 1346696382 | Megan Mari Byrne | Chiropractor | 8425 N 61st Dr., Glendale, AZ 85302 | 2016-05-09 |
| 1558742007 | Farzan Mojgani | Dentist | 5929 W. Peoria Ave. Suite 101, Glendale, AZ 85302 | 2015-06-10 |
| 1255757308 | Glendale Modern Dentistry, LLP | Dentist | 5143 West Olive Ave, Suite 140, Glendale, AZ 85302 | 2014-03-13 |
| 1518391341 | Crystal Nicole-marie Whitman | Physical Therapy Assistant | 5411 W. Cinnabar Ave., Glendale, AZ 85302 | 2013-08-28 |
| 1013349570 | A New Leaf | Clinic/Center | 8581 N 61st Ave, Building A, Suite 101-102, Glendale, AZ 85302 | 2013-08-06 |
| 1255602439 | Alicia S Fennemore | Specialist/Technologist | 352 E. Camelback Rd., Suite 102, Phoenix, AZ 85302 | 2012-01-20 |
| 1639306731 | Total Medical Care, LLC | Clinic/Center | 5048 W. Northern Avenue, Suite 105, Glendale, AZ 85302 | 2009-06-16 |
| Find all providers in zip 85302 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199481 | Steven Cleo Northern Jr. | Nurse Practitioner | 5820 W Greenway Rd Ste 124, Glendale, AZ 85306-3308 | 2020-09-17 |
| 1609493279 | Traci Marie Miramontes | Nurse Practitioner | 6001 W Northview Ave, Glendale, AZ 85301-1857 | 2020-06-30 |
| 1669097697 | Swazi Cromwell | Nurse Practitioner | 13408 N 53rd Ave, Glendale, AZ 85304-1378 | 2020-06-16 |
| 1922620590 | Bethany E Mainville | Nurse Practitioner | 8151 W Sierra Vista Dr, Glendale, AZ 85303-3217 | 2020-05-17 |
| 1184252678 | Revive Wellness and Rejuvenation LLC | Nurse Practitioner | 20229 N 67th Ave Ste C-a, Glendale, AZ 85308-6664 | 2020-03-30 |
| 1083247316 | Anna Lazzaro | Nurse Practitioner | 4760 W Ponderosa Ln, Glendale, AZ 85308-4872 | 2020-02-14 |
| 1760021422 | Judy Fong | Nurse Practitioner | 5220 W Dahlia Dr, Glendale, AZ 85304-1931 | 2019-12-29 |
| 1588207138 | Kristen Mitchell | Nurse Practitioner | 6922 W Kristal Way, Glendale, AZ 85308-5772 | 2019-10-25 |
| 1760038335 | Adrineh Kalantar Ohanian | Nurse Practitioner | 1139 E Lexington Dr, Glendale, CA 91206-3861 | 2019-08-09 |
| 1457904252 | Debra Goldman | Nurse Practitioner | 20325 N 51st Ave # 8, Glendale, AZ 85308-5674 | 2019-07-20 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on ALODIA BANUELOS DOMINGO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.