Provider Demographics
NPI:1730318809
Name:DOMINGUEZ-RIOS, SILVIA (LMFT)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:DOMINGUEZ-RIOS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:SILVIA
Other - Middle Name:
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:509-A 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4152
Mailing Address - Country:US
Mailing Address - Phone:916-548-5000
Mailing Address - Fax:
Practice Address - Street 1:1329 HOWE AVE STE 201
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3363
Practice Address - Country:US
Practice Address - Phone:916-548-5000
Practice Address - Fax:916-405-4244
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41380390200000X
CA78249106H00000X
390200000X
CA79182104100000X
CA174621041C0700X
CA626481041C0700X
CA121898106H00000X
CAIMF63581106H00000X
CAMFC#42263106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALMFT78249OtherBOARD OF BEHAVIORAL SCIENCES