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NPI Code Detail

MEDICARE: KIMBERLY SHARAI DOMINGUEZ-RIVERA

MEDICARE: KIMBERLY SHARAI DOMINGUEZ-RIVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult Companion
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1073368510
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY SHARAI DOMINGUEZ-RIVERA
Provider Business Mailing Address
First Line : 109 PARKHURST CIR UNIT D
Second Line :
City : APTOS
State : CA
Zip : 95003-9968
Country : US
Telephone Number : 831-498-7338
Fax Number :
Provider Business Practice Location Address
First Line : 104 WALNUT AVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-3900
Country : US
Telephone Number : 831-423-9444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2024
Last Update Date : 05/13/2026

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Directions to “ KIMBERLY SHARAI DOMINGUEZ-RIVERA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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