Jordan Marcus Dominguez
Behavior Technician in San Jose, CA. Individual provider (NPI-1).
NPI number1669947867
StatusActive
Last updated in NPPESOct 4, 2018
Details
- NPI
- 1669947867
- Entity type
- Individual (NPI-1)
- Name
- Jordan Marcus Dominguez
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 4, 2018
- Last updated
- Oct 4, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1101 S Winchester Blvd Ste N260San Jose, CA 95128-3901
Phone 408-654-9311
Mailing address
3392 San Mardo AveSan Jose, CA 95127-1135
Phone 925-822-8370
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 3,936 Behavior Technician providers in San Jose · All 25,183 providers in San Jose
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