DOMINIQUE SUZANNE CRAWFORD (NPI# 1982807665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982807665 |
| Entity Type | Individual |
| Full Name | DOMINIQUE SUZANNE CRAWFORD |
| Practice Address |
4645 Pacheco Blvd Martinez CA 94553-3625 |
| Mailing Address |
Po Box 1109 Martinez CA 94553-0110 |
| Practice Telephone | 9256469270 |
| Practice Fax Number | 9256469276 |
| Mailing Telephone | 9256469270 |
| Mailing Fax Number | 9256469276 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
070012BN | CA | Residential Treatment Facilities |
| Street Address |
4645 PACHECO BLVD |
| City | MARTINEZ |
| State | CA |
| Zip Code | 94553-3625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821168618 | Contra Costa County | Clinic/Center | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2006-11-08 |
| 1437768132 | Quincy Eileen Slatten | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2020-07-28 |
| 1336766799 | Leslie James Thurston | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2020-07-01 |
| 1144737362 | Michael B Connolly | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2018-01-09 |
| 1215488234 | Harrison Stewart | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2016-10-14 |
| 1023562535 | Neal Troiano | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2016-08-12 |
| 1578923223 | Toni Legree | Substance Abuse Rehabilitation Facility | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2016-02-23 |
| 1487036364 | Daniel S Petersen | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2015-06-26 |
| 1487076139 | Raul Roy Stephens Jr. | Counselor | 4645 Pacheco Blvd, Martinez, CA 94553-3625 | 2014-01-15 |
| 1467666594 | Discovery House | Substance Abuse Rehabilitation Facility | 4645 Pacheco Blvd, Martinez, CA 94553 | 2007-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043838709 | Melissa A Eaton | Health Educator | 200 Muir Rd., Attn Health Education Department, 3rd Floor, Ensenada Building, Martinez, CA 94553 | 2020-07-09 |
| 1427671965 | Kamri Elizabeth Hunt | Behavior Technician | 1220 Arnold Dr, Martinez, CA 94553 | 2020-05-19 |
| 1134741671 | Alex Rodriguez | Social Worker | 150 Nuir Road, Martinez, CA 94553 | 2020-05-07 |
| 1316405632 | Melissa Janine London | Psychologist | 150 Muir Road (116b), Martinez, CA 94553 | 2019-03-05 |
| 1942791025 | Morganne Elizabeth Lasley Juelich | Behavioral Analyst | 940 Lemon St, Martinez, CA 94553 | 2018-05-23 |
| 1457882243 | Ut Nguyen | Pharmacist | 400 Muir Rd, Martinez, CA 94553 | 2017-03-23 |
| 1346771144 | Irene Kuo | Pharmacist | 400 Muir Road, Martinez, CA 94553 | 2017-03-23 |
| 1407209802 | Gabrielle B De Los Reyes | Dentist | 1124 Arnold Drive #100, Martinez, CA 94553 | 2016-07-20 |
| 1619334745 | Randal Du | Pharmacist | 200 Muir Rd, Hacienda Bldg, Rm H1b18, Martinez, CA 94553 | 2016-01-20 |
| 1417329947 | Suja Samuel | Registered Nurse | 597 Center Avenue, Suite 200-a, Martinez, CA 94553 | 2015-10-23 |
| Find all providers in zip 94553 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275620 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 80 W Nicasio, San Geronimo, CA 94963 | 2020-11-05 |
| 1013518042 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1208 Via Aracena, Camarillo, CA 93010-7440 | 2020-11-05 |
| 1609477645 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 1850 Calle Alberca, Camarillo, CA 93010-1811 | 2020-11-05 |
| 1467053736 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 615 Bugeia Ln, Novato, CA 94945-1517 | 2020-11-04 |
| 1376144642 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 100 Avocado Pl, Camarillo, CA 93010-8467 | 2020-11-04 |
| 1285235556 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 7210 Johnston Rd, Pleasanton, CA 94588-9466 | 2020-11-04 |
| 1780282988 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 2891 I Street Ext, Petaluma, CA 94952-9521 | 2020-10-12 |
| 1720692577 | Muir Wood, LLC. | Substance Abuse Rehabilitation Facility | 1743 Skillman Lane, Petaluma, CA 94952-9495 | 2020-08-31 |
| 1598376816 | Muir Wood LLC | Substance Abuse Rehabilitation Facility | 6868 Cold Springs Rd, Penngrove, CA 94951-9722 | 2020-08-11 |
| 1770194060 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 195 S Peralta Hills Dr, Anaheim, CA 92807-3424 | 2020-08-11 |
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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.