MR. FERNANDO CARLOS DOMINGUEZ JR. (NPI# 1700078607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700078607 |
| Entity Type | Individual |
| Full Name | MR. FERNANDO CARLOS DOMINGUEZ JR. |
| Credential | LPT |
| Practice Address |
300 Hillmot Ave Ventura CA 93003 |
| Mailing Address |
300 Hillmont Ave Ventura CA 93003-1651 |
| Practice Telephone | 8056526727 |
| Mailing Telephone | 8056526727 |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2007-08-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 167G00000X | Licensed Psychiatric Technician | PT26056 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417196262 | Fernando Dominguez | Surgery | 507 Forest Road, Huntington, WV 25705 | 2009-02-18 |
| 1164936555 | Fernando Dominguez | Specialist/Technologist | 1130 Beachview St, Dallas, TX 75218-3700 | 2017-11-22 |
| 1972917672 | Fernando Dominguez | Internal Medicine | 4094 4th Ave, San Diego, CA 92103-2143 | 2014-06-20 |
| Street Address |
300 HILLMOT AVE |
| City | VENTURA |
| State | CA |
| Zip Code | 93003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645924 | Community Memorial Health System | Pharmacy | 2790 Loma Vista Road, Ventura, CA 93003 | 2020-06-29 |
| 1730702952 | Sarah Manon Begert | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave., Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-21 |
| 1033763677 | Ashley Danielle Aguilar | Counselor | 5740 Ralston Suite 100, Ventura, CA 93003 | 2019-08-01 |
| 1730747239 | Azadeh Ellsworth | Nurse Practitioner | 1752 S Victoria Ave Ste 250, Ventura, CA 93003 | 2019-05-31 |
| 1992275556 | Melissa Marie Cole | Social Worker | 4949 Market St, Ventura, CA 93003 | 2018-11-27 |
| 1851868400 | Weldon Acupuncture Professional Corporation | Acupuncturist | 3737 Telegraph Road, Suite F, Ventura, CA 93003 | 2018-10-31 |
| 1952876468 | Isabella Florencia Gallegos | Specialist/Technologist | 1857 Knoll Dr., Ventura, CA 93003 | 2018-10-11 |
| 1437645421 | Jill Huang Wong | Psychologist | 3585 Maple St Ste 248, Ventura, CA 93003 | 2018-07-02 |
| 1346735156 | Lisa Ngoc Thi Nguyen | Student in an Organized Health Care Education/Training Program | 147 N. Brent Street, Ventura, CA 93003 | 2018-06-25 |
| 1457845331 | Khloe Frank | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Suite 201, Ventura, CA 93003 | 2018-06-14 |
| Find all providers in zip 93003 | ||||
| Taxonomy Code | 167G00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Psychiatric Technician |
| An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659642320 | Michael Collier | Licensed Psychiatric Technician | 5810 Ralstron St, 2nd Floor, Ventura, CA 93003 | 2012-01-26 |
| 1124209739 | Kim Sloan | Licensed Psychiatric Technician | 1650 Palma Dr Ste 101, Ventura, CA 93003-5749 | 2007-11-26 |
| 1407970106 | Patrick Ben Oviedo Jr. | Licensed Psychiatric Technician | 300 Hillmont, Ventura, CA 93003 | 2007-03-19 |
| 1912057357 | Elizabeth J Matt | Licensed Psychiatric Technician | 5700 Ralston St Fl 2, Ventura, CA 93003-6050 | 2007-01-10 |
| 1346804515 | Tara Joy Urenda | Licensed Psychiatric Technician | 200 Hillmont Ave, Ventura, CA 93003-1647 | 2019-04-23 |
| 1528496684 | Shane Steelman | Licensed Psychiatric Technician | 200 Hillmont Ave, Ventura, CA 93003-1647 | 2013-10-28 |
| 1760720403 | Alicia Sarabia | Licensed Psychiatric Technician | 200 Hillmont Ave, Ventura, CA 93003-1647 | 2013-01-30 |
| 1215289145 | Diana R. Patton | Licensed Psychiatric Technician | 4258 Telegraph Rd, Ventura, CA 93003-3706 | 2012-10-02 |
| 1427354646 | Denise Bingham | Licensed Psychiatric Technician | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2011-02-04 |
| 1902107154 | Marjorie Swor | Licensed Psychiatric Technician | 300 Hillmont Ave, Ventura, CA 93003-1651 | 2010-11-04 |
| Find all providers in VENTURA | ||||
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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.