CRYSTAL GRACE DOMINGUEZ (NPI# 1851932255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851932255 |
| Entity Type | Individual |
| Full Name | CRYSTAL GRACE DOMINGUEZ |
| Practice Address |
391 Jenks Dr Corona CA 92880-2518 |
| Mailing Address |
15891 La Costa Alta Dr Moreno Valley CA 92555-5935 |
| Practice Telephone | 9499225988 |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366990772 | Crystal Dominguez | Speech-Language Pathologist | 315 E Clinton St, Hobbs, NM 88240-8238 | 2016-09-14 |
| 1750566527 | Crystal Regala Dominguez | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2007-12-29 |
| Street Address |
391 JENKS DR |
| City | CORONA |
| State | CA |
| Zip Code | 92880-2518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245743475 | Ailsa Reyes | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2017-11-09 |
| 1992318810 | Cassidy Claveau | Behavior Technician | 391 Jenks Dr, Corona, CA 92878-5018 | 2020-08-29 |
| 1003434929 | Ikeeshya Gibson | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2020-07-07 |
| 1093330292 | Alicia D Lauderdale | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2020-06-12 |
| 1285259663 | Daniela Camacho | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2020-06-11 |
| 1215560602 | Rosa Mendoza | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2020-02-13 |
| 1619515319 | Tia Johnson | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2019-12-13 |
| 1386288561 | Earl Jackson | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2019-10-31 |
| 1013564780 | Sarah Bayaa | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2019-08-19 |
| 1700438975 | Deja Bibbs | Behavior Technician | 391 Jenks Dr, Corona, CA 92880-2518 | 2019-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084945 | Eastvale Family Care Inc. | Family Medicine | 14252 Schleisman Rd., Eastvale, CA 92880 | 2020-05-08 |
| 1982226460 | Eastvale Urgent Care Inc | Clinic/Center | 14252 Schleisman Rd, Eastvale, CA 92880 | 2020-05-07 |
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1184274029 | Rocquel Mack | Licensed Vocational Nurse | 2131 Shelley Circle, Corona, CA 92880 | 2019-09-12 |
| 1255993176 | Symbiosis, Inc. | Clinic/Center | 3115 Palisades Drive, Corona, CA 92880 | 2019-07-01 |
| 1770065559 | Kumkum Mehta | Nurse Practitioner | 7391 Sungold Ave, Corona, CA 92880 | 2018-08-29 |
| 1629559802 | Skt Therapy Inc | Marriage & Family Therapist | 765 N Main St Ste 152, Corona, CA 92880 | 2018-08-24 |
| 1356854145 | Hk Durgs Inc | Pharmacy | 13394 Limonite Ave, Ste 120, Eastvale, CA 92880 | 2017-11-15 |
| 1134638653 | National Vision, Inc. | Technician/Technologist | 482 Main Street, Corona, CA 92880 | 2017-09-27 |
| 1922527464 | Crown Care Transportation | Non-emergency Medical Transport (VAN) | 13557 Nectarine Ave, Corona, CA 92880 | 2017-09-15 |
| Find all providers in zip 92880 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831015 | Ayanna D Davis | Behavior Technician | 425 E Monterey Rd, Corona, CA 92879-2839 | 2020-11-06 |
| 1790386167 | Chirley Oviedo | Behavior Technician | 285 S Vicentia Ave Apt 3, Corona, CA 92882-2157 | 2020-11-03 |
| 1609475722 | Tahmea Henderson | Behavior Technician | 225 Rincon St. #219, Corona, CA 92879 | 2020-10-20 |
| 1477180313 | Dewa Karzi | Behavior Technician | 557 Fairbanks St, Corona, CA 92879-5845 | 2020-03-23 |
| 1427682608 | Toni Atkinson | Behavior Technician | 1670 Via Pacifica Apt H201, Corona, CA 92882-4415 | 2020-02-26 |
| 1093348666 | Michiko Morales | Behavior Technician | 535 Richey St Apt 110, Corona, CA 92879-6181 | 2020-02-21 |
| 1114558079 | Alicia Marie Hamilton | Behavior Technician | 980 Hedges Dr, Corona, CA 92880-7355 | 2020-01-30 |
| 1285285213 | Mariann H Kim | Behavior Technician | 2815 Camellia Ct, Corona, CA 92882-3640 | 2019-09-20 |
| 1215587191 | Karla Vasquez | Behavior Technician | 1034 Westbrook St, Corona, CA 92880-1215 | 2019-09-12 |
| 1811544869 | Bryan L Moore | Behavior Technician | 9247 Plume Grass St, Corona, CA 92883-8166 | 2019-08-23 |
| Find all providers in CORONA | ||||
Please comment or provide details below to improve the information on CRYSTAL GRACE 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.