MEDICARE: RITA GENOVEVA DOMINGUEZ ROMAN CHW2

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
1	172V00000X	Community Health Worker
2	101YP1600X	Pastoral Counselor		NV
3	172V00000X	Community Health Worker	207Q00000X	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	193200000X	OTHER	NV	MULTI SPECIALTY-GROUP

General Provider Information

NPI Number	:	1396521241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA GENOVEVA DOMINGUEZ ROMAN CHW2

Provider Business Mailing Address
First Line	:	6285 ANGORA PEAK LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-1662
Country	:	US
Telephone Number	:	954-860-3216
Fax Number	:

Provider Business Practice Location Address
First Line	:	6285 ANGORA PEAK LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-1662
Country	:	US
Telephone Number	:	954-860-3216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	12/05/2025

Similar Medicare Providers

1720836570 — PREVENTION GAMBLER FOUNDATION
Practice Location Address:

6285 ANGORA PEAK LN
LAS VEGAS, NV
89115-1662

Practice Phone: 954-860-3216
Practice Fax:

1932041134 — ANTONIO WILLIS
Practice Location Address:

1950 SIMMONS ST APT 1190
LAS VEGAS, NV
89106-1662

Practice Phone: 725-599-5720
Practice Fax:

1518109560 — MRS. THUY TRANG THI HUYNH
Practice Location Address:

1662 SILVER KNOLL AVE
LAS VEGAS, NV
89123

Practice Phone: 702-896-5756
Practice Fax:

1154263432 — PILLPACK LLC
Practice Location Address:

5005 EAST NORTH BELT ROAD, SUITE 100
NORTH LAS VEGAS, NV
89115

Practice Phone: 855-745-5725
Practice Fax:

1417940933 — FAMILY MEDICAL OF NEVADA, INC.
Practice Location Address:

4230 N PECOS RD
LAS VEGAS, NV
89115-0196

Practice Phone: 702-643-6639
Practice Fax: 702-643-0208

1194783530 — DR. BRADLEY S WALKER M.D.
Practice Location Address:

1735 N NELLIS BLVD STE G
LAS VEGAS, NV
89115-3671

Practice Phone: 702-342-8804
Practice Fax:

Directions to “ RITA GENOVEVA DOMINGUEZ ROMAN CHW2” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.