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BRIAN LEE DOMITROVICH SUDCC II
NPI 1467060798
Day Training/Habilitation Specialist in Oakland, CA

Active since July 22, 2020
280 17TH ST, OAKLAND, CA 94612(510) 238-5020 Get Directions Write a Review

NPPES record last updated: April 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 7, 2026, Mar 31, 2026, Jan 5, 2024 and 2 more (5 updates tracked since 2020).

About Brian Lee Domitrovich Sudcc Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIAN LEE DOMITROVICH SUDCC II (NPI 1467060798) is an individual day training/habilitation specialist in Oakland, California, licensed in California (13534) and active in the NPI registry since July 2020. She maintains a secondary practice location in Oakland.

NPPES Registry Identity

NPI1467060798
Entity TypeIndividualFemale
Primary Taxonomy373H00000X
Provider Legal NameBRIAN LEE DOMITROVICHCredential: SUDCC II
Location Address280 17TH STOakland, CA 94612-4124
Mailing Address6649 Foothill Blvd Unit 2Oakland, CA 94605-2018 · (415) 318-0375
Phone(510) 238-5020
Sole ProprietorNo
Enumeration DateJuly 22, 2020
Last NPPES UpdateApril 7, 20265 updates tracked since enumeration
NPPES CertifiedApril 7, 2026
✔ NPI 1467060798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDay Training/Habilitation SpecialistNursing Service Related Providers
Taxonomy Code373H00000X
License✔ Licensed in CA · 13534
Definition
Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 13534 (CA)
280 17TH ST, Oakland, CA 94612
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Other Names 1

Other Name (5)Raquel Amber Santiago Sud Counselor

Secondary Practice Location 1

Location 12577 San Pablo AveOakland, CA 94612-1159 · Phone (510) 466-6100

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARCELA L. PEREZ
Registered Nurse
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020
XIANJA BARROW
Case Management
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020
MRS. MARITZA COREA
Counselor (Mental Health)
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020
NOEL MILAN
Counselor (Mental Health)
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020
JAMES PRECOUR
Technician, Health Information
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020
KRISTINA P SMITH
Counselor (Professional)
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 514-5948
MS. DESIREE ALVAREZ
Rehabilitation Practitioner
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020
SYDNEY WILSON
Registered Nurse (Psychiatric/Mental Health)
280 17TH ST
OAKLAND, CA 94612
Alameda County (510) 238-5020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brian Domitrovich's NPI number?

The NPI number for Brian Domitrovich is 1467060798. It was assigned to this individual provider in the NPPES registry on July 22, 2020. The provider is also known as Raquel Amber Santiago Sud Counselor.

Where is Brian Domitrovich located?

Brian Domitrovich practices at 280 17th St, Oakland, CA 94612. The listed phone number is (510) 238-5020.

What is Brian Domitrovich's specialty?

The primary specialty registered for this NPI is Day Training/Habilitation Specialist with taxonomy code 373H00000X.

When was this NPI record last updated?

The NPPES record for Brian Domitrovich was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.