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NPI Code Detail

MEDICARE: DOMINIQUE N TARANGO MA, MFT

MEDICARE: DOMINIQUE N TARANGO MA, MFT
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
1106H00000XMarriage & Family Therapist138577CA

General Provider Information

NPI Number : 1841991080
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE N TARANGO MA, MFT
Provider Business Mailing Address
First Line : 8989 RIO SAN DIEGO DR STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1647
Country : US
Telephone Number : 858-279-1223
Fax Number :
Provider Business Practice Location Address
First Line : 8989 RIO SAN DIEGO DR STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1647
Country : US
Telephone Number : 858-279-1223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2023
Last Update Date : 05/21/2026

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