NICOLE DOMINGUEZ (NPI# 1811422058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811422058 |
| Entity Type | Individual |
| Full Name | NICOLE DOMINGUEZ |
| Practice Address |
205 Pasadena Ave South Pasadena CA 91030-2919 |
| Practice Telephone | 3233445536 |
| Mailing Telephone | 3233445536 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MFTI 98403 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 7708 | 01 |
| CA | MEDI-CAL | 7368 | 01 |
| CA | MEDI-CAL | 7184 | 01 |
| CA | MEDI-CAL | 7667 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093341760 | Nicole Elizabeth Dominguez | Physical Therapist | 6300 Kingery Hwy Ste 100, Willowbrook, IL 60527-2250 | 2020-03-13 |
| 1437700200 | Nicole Leann Dominguez | Social Worker | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2019-09-24 |
| 1871025833 | Nicole Dominguez | Student in an Organized Health Care Education/Training Program | 2401 S 31st St, Temple, TX 76508-0001 | 2017-03-29 |
| 1164791232 | Nicole Brenes Dominguez | Pharmacist | 1847 Rockaway Pkwy, Brooklyn, NY 11236-5307 | 2011-12-20 |
| Street Address |
205 PASADENA AVE |
| City | SOUTH PASADENA |
| State | CA |
| Zip Code | 91030-2919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750410098 | Azalea Ann Becerra | Marriage & Family Therapist | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2007-03-04 |
| 1235730342 | Abigail Avalos | Counselor | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-11-04 |
| 1730795089 | Sarah Margaret Potter | Counselor | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-09-22 |
| 1003422007 | Qing Ye | Counselor | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-09-16 |
| 1689295172 | Zanetta Anne Chichester | Social Worker | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-05-06 |
| 1366062119 | Eliza Nava Romero | Case Manager/Care Coordinator | 205 Pasadena Ave, South Pasadena, CA 91030 | 2020-04-22 |
| 1588284590 | Jessica Varela | Case Manager/Care Coordinator | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-04-20 |
| 1669004156 | Diana Karen Marias | Case Manager/Care Coordinator | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-02-12 |
| 1487286746 | Briahna Nicole Manier | Social Worker | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2020-02-05 |
| 1891338091 | Odette Alejandra Reyes | Counselor | 205 Pasadena Ave, South Pasadena, CA 91030-2919 | 2019-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444674 | Heather Marie Delman | Marriage & Family Therapist | 1425 Oneonta Knoll, So Pasadena, CA 91030 | 2020-10-09 |
| 1568986883 | Richard Gonzalez | Behavior Technician | 625 S Fair Oaks Ave #300, South Pasadena, CA 91030 | 2017-07-28 |
| 1366991150 | Nereida Acosta | Behavioral Analyst | 625 S Fair Oaks Ave, Suite 200, South Pasadena, CA 91030 | 2016-09-22 |
| 1043618192 | Clelia Alonzo | Specialist | 1317 Huntington Dr., Cos Services Building, South Pasadena, CA 91030 | 2014-12-05 |
| 1740687359 | Francisco Acosta | Behavioral Analyst | 625 S Fair Oaks Ave, Suite 300, South Pasadena, CA 91030 | 2014-11-25 |
| 1700289030 | James Y. Law | Pharmacist | 1678 Camino Lindo, S. Pasadena, CA 91030 | 2014-10-01 |
| 1760893994 | Joanna Ku | Rehabilitation Practitioner | 1855 Hill Drive, South Pasadena, CA 91030 | 2014-05-09 |
| 1336568294 | Sarah Sicher | Psychiatry & Neurology | 729 Mission St Ste 300, South Pasadena, CA 91030 | 2014-04-08 |
| 1265799530 | Xiaodong Li | Pathology | 314 Monterey Rd Unit 14, South Pasadena, CA 91030 | 2012-04-11 |
| 1831477124 | South Pasadena General Dentistry Inc | Dentist | 1506 Huntington Drive, South Pasadena, CA 91030 | 2011-08-03 |
| Find all providers in zip 91030 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194333401 | Lisa Patrizia | Counselor | 2033 Alpha St, South Pasadena, CA 91030-4220 | 2020-07-22 |
| 1528556651 | Path To Growth Counseling Inc. | Counselor | 1015 Fremont Ave Fl 2, South Pasadena, CA 91030-3224 | 2018-04-24 |
| 1780071894 | Pak Nin Poon | Counselor | 1015 Fremont Ave, South Pasadena, CA 91030-3224 | 2015-04-16 |
| 1427447838 | Dawna Bilodeau | Counselor | 1180 Rue Des Rois, Unit 2b, South Pasadena, FL 33707-2840 | 2015-01-22 |
| 1588090617 | Julie Nan Lauderdale-garzia | Counselor | 6901 S Shore Dr S, South Pasadena, FL 33707-4621 | 2013-09-20 |
| 1437422722 | Christina Taylor | Counselor | 1234 Huntington Dr, Apartment 3, South Pasadena, CA 91030-4551 | 2012-02-16 |
| 1174896401 | Luz Ayon | Counselor | 808 Orange Grove Pl, South Pasadena, CA 91030-3110 | 2012-02-16 |
| 1124159801 | Hathaway-sycamores Child and Family Services | Counselor | 625 Fair Oaks Ave Ste 358, South Pasadena, CA 91030-5812 | 2007-03-07 |
| 1477697001 | Linda L Longserre | Counselor | 1000 Fremont Ave Ste 202, South Pasadena, CA 91030-3225 | 2007-02-16 |
| 1881619328 | Alexander J Chapunoff | Counselor | 1135 Pasadena Ave S, Suite 309, South Pasadena, FL 33707-2887 | 2006-07-13 |
| Find all providers in SOUTH PASADENA | ||||
| City | SOUTH PASADENA |
| Zip Code | 91030 |
Please comment or provide details below to improve the information on NICOLE 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.