DAVID DOMINGUEZ-MAEZ (NPI# 1366944308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366944308 |
| Entity Type | Individual |
| Full Name | DAVID DOMINGUEZ-MAEZ |
| Credential | LSAA |
| Practice Address |
1227 N Railroad Ave Espanola NM 87532-3147 |
| Practice Telephone | 5057478187 |
| Practice Fax Number | 5057478306 |
| Mailing Telephone | 5057478187 |
| Mailing Fax Number | 5057478306 |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0180121 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 1265683049 | 05 |
| Street Address |
1227 N RAILROAD AVE |
| City | ESPANOLA |
| State | NM |
| Zip Code | 87532-3147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467413021 | Roswell Home Medical Inc | Durable Medical Equipment & Medical Supplies | 1227 N Railroad Ave, Suite A-6, Espanola, NM 87532-3147 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690423 | David A. Bustos | Non-emergency Medical Transport (VAN) | 1736 Calle Culebra, Espanola, NM 87532 | 2020-08-24 |
| 1407484942 | Rosita Lorreyna Sanchez | Behavior Technician | 3 Calle Baca, Espanola, NM 87532 | 2020-03-30 |
| 1437615564 | Troy Campbell | Counselor | 19525 Tomas Ln, Espanola, NM 87532 | 2019-02-13 |
| 1174099428 | Marisa Anaya | Registered Nurse | 420 N Coronado Ave, Espanola, NM 87532 | 2018-10-15 |
| 1780169938 | Celina Velasquez | Specialist/Technologist | 8 Camino Velasquez Ln., Espanola, NM 87532 | 2018-10-03 |
| 1356864656 | Jacqueline Andrea Zamora Alvarado | Behavior Technician | 3 Boneyard Rd, Espanola, NM 87532 | 2017-07-19 |
| 1619423902 | Mariah Maureen Martinez | Specialist/Technologist | 1421 Montana Vista St, Espanola, NM 87532 | 2016-08-28 |
| 1851847180 | Shannon Vigil | Perfusionist | 829 Calle Juan Jose Vigil, Espanola, NM 87532 | 2016-08-28 |
| 1144684234 | Tanya P. Reyes | Family Medicine | El Centro Family Health, 2010 Industrial Park Rd., Espanola, NM 87532 | 2016-04-05 |
| 1780058768 | Kale Lee Dennis | Massage Therapist | 2 Old Orchard Ln, Espanola, NM 87532 | 2015-11-13 |
| Find all providers in zip 87532 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669941209 | Mukta Kaur Khalsa | Counselor | 1 Ram Das Guru Pl, Espanola, NM 87532-8213 | 2018-11-13 |
| 1013240308 | Peter H Goodwin | Counselor | 1114 Plaza Del Norte, Suite B, Espanola, NM 87532-3216 | 2009-09-17 |
| 1124351416 | Wayne A Salazar | Counselor | 1114 Plaza Del Norte Ste B, Espanola, NM 87532-3216 | 2009-09-17 |
| 1023186053 | Edna Elizabeth Gonzales-anzaldua | Counselor | 818 S Mccurdy Rd, Espanola, NM 87532-9646 | 2006-11-30 |
| 1568551687 | Louise Sanchez | Counselor | 904 Fairview Drive, Suite B, Espanola, NM 87532 | 2006-10-12 |
| 1336761287 | Meghan Trujillo I | Counselor | 1227 N Railroad Ave Ste C, Espanola, NM 87532-3159 | 2020-05-14 |
| 1740811207 | Charmaine Cata | Counselor | 1227 N Railroad Ave Ste C, Espanola, NM 87532-3159 | 2020-02-03 |
| 1821633587 | Darrin's Place LLC | Counselor | 720 E Hacienda St, Espanola, NM 87532-2523 | 2019-11-16 |
| 1174175467 | Michael Joseph Zengerle | Counselor | 1227 N Railroad Ave Ste C, Espanola, NM 87532-3159 | 2019-07-16 |
| 1538633870 | John Garland | Counselor | 2010 Industrial Park Rd, Espanola, NM 87532-3600 | 2019-01-21 |
| Find all providers in ESPANOLA | ||||
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| 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.