Provider Demographics
NPI:1578895488
Name:DOMAGUIN, DANIEL RITUA (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:RITUA
Last Name:DOMAGUIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10265 ROCKINGHAM DR # 100-4013
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2523
Mailing Address - Country:US
Mailing Address - Phone:916-229-6461
Mailing Address - Fax:
Practice Address - Street 1:10265 ROCKINGHAM DR # 100-4013
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2523
Practice Address - Country:US
Practice Address - Phone:916-229-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 647471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical