DOMONIQUE MARTIN (NPI# 1740757780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740757780 |
| Entity Type | Individual |
| Full Name | DOMONIQUE MARTIN |
| Practice Address |
8626 Lower Sacramento Rd Stockton CA 95210-1835 |
| Mailing Address |
5315 Carrington Cir Apt A34 Stockton CA 95210-3549 |
| Practice Telephone | 2094782487 |
| Mailing Telephone | 2092980352 |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841667599 | Domonique Marie Martin | Physical Therapist | 720 Montclair Rd, Suite 202, Birmingham, AL 35213-1964 | 2015-08-28 |
| Street Address |
8626 LOWER SACRAMENTO RD |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-1835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275607327 | Richard Vernell Morris | Counselor | 8626 Lower Sacramento Rd, Stockton, CA 95210 | 2006-11-20 |
| 1255965380 | Audree Mendez | Counselor | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2020-02-27 |
| 1407323777 | Dora Raquel Berry | Licensed Vocational Nurse | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2018-10-25 |
| 1457828865 | Lynda Elizabeth Becerra | Licensed Vocational Nurse | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2018-10-24 |
| 1649622028 | Sarah Barr | Counselor | 8626 Lower Sacramento Rd, 41, Stockton, CA 95210-1835 | 2016-07-08 |
| 1538529706 | Samantha Malough | Counselor | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2016-03-02 |
| 1689059388 | Stephanie Alfaro Duenas | Counselor | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2015-07-23 |
| 1770967465 | Aegis Treatment Center, LLC. | Community/Behavioral Health | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2015-07-13 |
| 1396124194 | Denise Gonzalez | Counselor | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2015-05-26 |
| 1689068256 | Kenneth Lindberg | Counselor | 8626 Lower Sacramento Rd, Stockton, CA 95210-1835 | 2015-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893155 | Tracey Black | Counselor | 130 W Flora St, Stockton, CA 95202-1636 | 2020-08-25 |
| 1699305508 | Juan Robles | Counselor | 1947 N California St # 95204, Stockton, CA 95204-6029 | 2020-01-20 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1821648353 | Kaye Lynn Scott-roy | Counselor | 285 H Rd, Stockton, KS 67669-8889 | 2019-09-17 |
| 1760049043 | Jay Frank Williams | Counselor | 1105 N El Dorado St, Stockton, CA 95202-1305 | 2019-05-22 |
| 1184105462 | Rachelle Diane Wilson | Counselor | 2733 N Sutter St, Stockton, CA 95204-4548 | 2018-08-24 |
| 1568943835 | Heather Lynn Rogers | Counselor | 3990 Black Butte Cir, Stockton, CA 95209-3500 | 2018-08-24 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1760995781 | Dana Lamont Harris | Counselor | 2833 Buckner Ct, Stockton, CA 95207-2302 | 2017-11-13 |
| Find all providers in STOCKTON | ||||
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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.