Healthcare Provider Details

I. General information

NPI: 1730318809
Provider Name (Legal Business Name): SILVIA DOMINGUEZ-RIOS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SILVIA DOMINGUEZ M.S.

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 HOWE AVE STE 201
SACRAMENTO CA
95825-3363
US

IV. Provider business mailing address

509-A 4TH ST
DAVIS CA
95616-4152
US

V. Phone/Fax

Practice location:
  • Phone: 916-548-5000
  • Fax: 916-405-4244
Mailing address:
  • Phone: 916-548-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number79182
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17462
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number62648
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number78249
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number121898
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF63581
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC#42263
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMFC41380
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: