Ms Rosalva Dominguez, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Santa Fe Springs, California. Her current practice location is
11731 Telegraph Rd Ste K, Santa Fe Springs, California. You can reach out to her office (for appointments etc.) via phone at
(562) 907-7429.
Ms Rosalva Dominguez is licensed to practice in California (license number LCSW91222) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366623811.
Healthcare Provider's Profile
| Full Name | Ms Rosalva Dominguez |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 11731 Telegraph Rd Ste K, Santa Fe Springs, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1366623811
- Provider Enumeration Date: 11/26/2007
- Last Update Date: 01/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 0547669194
- Enrollment ID: I20210601002654
Medical Identifiers
Medical identifiers for Ms Rosalva Dominguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366623811 | NPI | - | NPPES |
| 101YM0800X | Other | CA | ASSOCIATE CLINICAL SOCIAL WORKER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | ASW 22403 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 91222 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW91222 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Rosalva Dominguez allows following entities to bill medicare on her behalf.
| Entity Name | Pacific Clinics |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255496105
PECOS PAC ID: 4082008420
Enrollment ID: O20220228001926 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Rosalva Dominguez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Rosalva Dominguez, LCSW
2214 Redwood Ave,
Ontario, CA 91762-6346
Ph: (562) 205-6156 | Ms Rosalva Dominguez, LCSW
11731 Telegraph Rd Ste K,
Santa Fe Springs, CA 90670-6815
Ph: (562) 907-7429 |
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