AMANDA ANTOINETTE DOMINGUEZ (NPI# 1265059307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265059307 |
| Entity Type | Individual |
| Full Name | AMANDA ANTOINETTE DOMINGUEZ |
| Other Name | AMANDA ANTOINETTE JENSEN |
| Credential | PA-C |
| Practice Address |
1240 S Westlake Blvd Ste 205 Westlake Village CA 91361-1992 |
| Mailing Address |
6584 Pinnacle Ct Moorpark CA 93021-1272 |
| Practice Telephone | 8054950551 |
| Mailing Telephone | 3102703716 |
| Enumeration Date | 2020-07-05 |
| Last Update Date | 2020-07-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA17489 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 301 Science Dr Ste 280, Moorpark, CA 930210803 | 8055307110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184135139 | Amanda Dominguez | Behavior Technician | 10300 Sw 72nd St Ste 114, Miami, FL 33173-3038 | 2017-10-17 |
| 1174032205 | Amanda Dominguez | Community Health Worker | 4560 S Eastern Ave Ste 15, Las Vegas, NV 89119-6182 | 2017-09-20 |
| 1396108338 | Amanda Dominguez | Occupational Therapist | 1635 Ohio St, Watertown, NY 13601-3032 | 2016-03-29 |
| 1023419785 | Amanda Sims Dominguez | Pharmacist | 4974 Highway 3276 Ste B, Stonewall, LA 71078-9335 | 2014-09-11 |
| Street Address |
1240 S WESTLAKE BLVD STE 205 |
| City | WESTLAKE VILLAGE |
| State | CA |
| Zip Code | 91361-1992 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871627372 | Asc Ca LLC | Clinic/Center | 1240 S Westlake Blvd Ste 205, Westlake Village, CA 91361-1992 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093328379 | Lauren Kaprielian Davidson | Speech-Language Pathologist | Fox Therapy Services, 31822 Village Center Rd, Ste. 107, Westlake Village, CA 91361 | 2020-08-26 |
| 1679118749 | Min A Baek | Optometrist | 4353 Park Terrace Dr., #150, Westlake Village, CA 91361 | 2019-11-13 |
| 1417429952 | Kimberly Joanne Yudt | Behavioral Analyst | 660 Hampshire Road, Suite 100, Westlake Village, CA 91361 | 2018-12-21 |
| 1932671773 | Rachel Sonya Chistyakov | Marriage & Family Therapist | 32107 Undero Canyon Rd, Suite 203, Westlake Village, CA 91361 | 2018-12-18 |
| 1447778394 | Spirit Healthcare Hospice, Inc. | Hospice Care, Community Based | 30941 Agoura Rd., Suite 112, Westlake Village, CA 91361 | 2017-08-30 |
| 1023556313 | Lindsay Gooze | Marriage & Family Therapist | 38122 Village Center Rd., Ste.102, Westlake Village, CA 91361 | 2017-02-07 |
| 1851839419 | Casey J. Simon | Counselor | 1800 Bridgegate Street, Suite #108, Westlake Village, CA 91361 | 2017-02-03 |
| 1689124851 | David Schwartz | Marriage & Family Therapist | 30961 Agoura Rd Ste 215, Westlake Village, CA 91361 | 2016-10-11 |
| 1932655735 | Sherry Safavi | Counselor | 677 Colorado Blivd, Los Angeles, CA 91361 | 2016-08-31 |
| 1053795393 | Kashmir Trading Inc. | Durable Medical Equipment & Medical Supplies | 790 Hampshire Rd. Ste #b, Westlake Village, CA 91361 | 2015-07-16 |
| Find all providers in zip 91361 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
| City | WESTLAKE VILLAGE |
| Zip Code | 91361 |
Please comment or provide details below to improve the information on AMANDA ANTOINETTE DOMINGUEZ.
| 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.