MR. MICHAEL WILLIAM DOMINISSE JR. (NPI# 1962914580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962914580 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL WILLIAM DOMINISSE JR. |
| Credential | PA |
| Practice Address |
111 Alvaston Ct Folsom CA 95630-8614 |
| Practice Telephone | 9164027388 |
| Mailing Telephone | 9164027388 |
| Enumeration Date | 2017-11-05 |
| Last Update Date | 2017-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
111 ALVASTON CT |
| City | FOLSOM |
| State | CA |
| Zip Code | 95630-8614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1174153027 | Haley Harmon | Nurse Practitioner | 1621 Creekside Dr. Creekside Ob/gyn, Ste. 102, Folsom, CA 95630 | 2020-01-20 |
| 1932741469 | Ruma Ramani Jolly | Speech-Language Pathologist | 250 Mc Adoo Drive, Willow Springs, Apt.911, Folsom, CA 95630 | 2019-10-16 |
| 1750844767 | Sharon Munyaanyi | Registered Nurse | 1600 Creekside Dr Ste 3700, Folsom, CA 95630 | 2019-04-08 |
| 1104308345 | Stephanie Whatley | Optometrist | 2390 E Bidwell St Ste 400, Folsom, CA 95630 | 2018-09-04 |
| 1447746607 | Heather Michellee Thrapp | Behavioral Analyst | 125 Oak Ravine Way, Folsom, CA 95630 | 2018-07-10 |
| 1700370483 | Loretta May Delgado | Behavior Technician | 322 Crow Cany, Folsom, CA 95630 | 2018-06-18 |
| 1417448176 | Sound Support Inc. | Hearing Instrument Specialist | 610 East Bidwell Street, Suite A, Folsom, CA 95630 | 2018-05-29 |
| 1548750144 | Don Peterson Md, Sugical Assisting | General Practice | Mercy Hospital of Folsom (dignity Health Folsom), 1650 Creekside Dr., Folsom, CA 95630 | 2018-05-18 |
| 1245733328 | American Heritage Hospice Inc | Hospice Care, Community Based | 1837 Iron Point Rd Ste 180, Folsom, CA 95630 | 2018-03-14 |
| Find all providers in zip 95630 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003219601 | Wei Kuang | Physician Assistant | 1561 Creekside Dr Ste 170, Folsom, CA 95630-3495 | 2014-09-27 |
| 1881878247 | Melissa G Rossi | Physician Assistant | 1611 Creekside Dr Ste 102, Suite 602, Folsom, CA 95630-3490 | 2007-12-20 |
| 1962564542 | Amy Zmyslinski | Physician Assistant | 1745 Creekside Dr, Folsom, CA 95630 | 2006-12-13 |
| 1144226077 | Michael G Outslay | Physician Assistant | 1730 Prairie City Road, Suite 120, Folsom, CA 95630 | 2005-06-24 |
| 1043828262 | Ramon Simpson | Physician Assistant | 1050 Iron Point Rd, Folsom, CA 95630-8013 | 2020-07-14 |
| 1609343102 | Yanyan Hollingsworth | Physician Assistant | 510 Plaza Dr Ste 170, Folsom, CA 95630-4790 | 2018-11-01 |
| 1376054650 | John Griffith Hume | Physician Assistant | 1650 Creekside Dr, Folsom, CA 95630-3400 | 2017-10-13 |
| 1528586245 | Kevin Alan Palm | Physician Assistant | 1650 Creekside Dr, Folsom, CA 95630 | 2017-09-01 |
| 1245623297 | Crystal Whitlow Rizzo | Physician Assistant | 2170 E Bidwell St, #100, Folsom, CA 95630-6465 | 2015-03-16 |
| 1104254671 | Gaby Sibo | Physician Assistant | 1600 Creekside Dr, Suite 3800, Folsom, CA 95630-3444 | 2013-10-21 |
| Find all providers in FOLSOM | ||||
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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.