DOMINIQUE MORTENSEN (NPI# 1386196715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386196715 |
| Entity Type | Individual |
| Full Name | DOMINIQUE MORTENSEN |
| Practice Address |
475 W 260 N Orem UT 84057-1970 |
| Practice Telephone | 8012219930 |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1396085718 | 05 |
| Street Address |
475 W 260 N |
| City | OREM |
| State | UT |
| Zip Code | 84057-1970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093746943 | Kids On The Move, Inc. | Day Training, Developmentally Disabled Services | 475 W 260 N, Orem, UT 84057-1970 | 2006-07-06 |
| 1518568641 | Vedana Leidy Gaul | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-11-04 |
| 1982205357 | Carol Tonga | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-11-03 |
| 1457951881 | Hannah Kathryn Disney | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-10-26 |
| 1073111704 | Ruth Talbot | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-10-14 |
| 1588271134 | Jess Nussbaum | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-09-28 |
| 1568075323 | James S Ng | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-08-30 |
| 1932712585 | Emily Smith Carol Smith | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-08-24 |
| 1194338715 | Camyll Broadhead | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-08-24 |
| 1760093280 | Miiko Masse | Behavior Technician | 475 W 260 N, Orem, UT 84057-1970 | 2020-08-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013529932 | Jessica Chang | Social Worker | 870 W, Center, UT 84057 | 2020-08-21 |
| 1750991402 | Dr. Alexander B. Larsen Dds | Dentist | 385 W. Center Street, Orem, UT 84057 | 2020-08-07 |
| 1750911996 | Joanna Ramirez | Behavioral Analyst | 1443 West 800 North #103, Orem, UT 84057 | 2020-01-15 |
| 1790321842 | Nicole Rose Mcdougal | Speech-Language Pathologist | 527 400 N, Ste 2, Orem, UT 84057 | 2019-11-25 |
| 1871151837 | Robert B Fujiki | Speech-Language Pathologist | 1935 N90 W, Orem, UT 84057 | 2019-06-04 |
| 1669965562 | Brian Quigley Inc. | Hearing Instrument Specialist | 895 West Center Street, Orem, UT 84057 | 2018-06-14 |
| 1568960250 | Catherine Collins | Nurse Practitioner | 700 W. 800 N., Suite 220, Orem, UT 84057 | 2018-01-27 |
| 1821596073 | Venice Lucia Wilkes | Physician Assistant | 700 W 800 N # 220, Orem, UT 84057 | 2018-01-23 |
| 1851811160 | Jessie Carlson | Behavior Technician | 475 West 260 North, Orem, UT 84057 | 2017-06-27 |
| 1588013890 | Li Ping Su | Marriage & Family Therapist | 1027 W 1033 N, S108, Orem, UT 84057 | 2016-06-07 |
| Find all providers in zip 84057 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891264701 | Brynna Lynn Tanner | Technician, Other | 1875 S Geneva Rd, Orem, UT 84058-2217 | 2018-11-20 |
| 1790228104 | Cheryl Bell | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-12-02 |
| 1558803957 | Adam Hunt | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-11-16 |
| 1760934509 | Crystal Hill | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-10-27 |
| 1447702329 | Megan Adams | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-10-26 |
| 1861840902 | Madyline Spencer | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-05-31 |
| 1013365170 | Joshua Woolstenhulme | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-05-31 |
| 1396193421 | Mckenzi Davis | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-05-31 |
| 1144678277 | Lucy Morgan | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-05-31 |
| 1245688324 | Christine Spicker | Technician, Other | 475 W 260 N, Orem, UT 84057-1970 | 2016-05-30 |
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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.