MRS. SUSAN DOMINGUEZ PSY24264
NPI 1477709483
Psychologist - Intellectual and Developmental Disabilities in Berkeley, CA
NPI Status: Active since August 09, 2008
Contact Information
3200 ADELINE ST
BERKELEY, CA
ZIP 94703
Phone: (510) 601-0203
Fax: (510) 601-4002
- Individual
- Female
- Psychologist
- Intellectual and Developmental Disabilit...
- PECOS Enrolled
About SUSAN DOMINGUEZ
This page provides the complete NPI Profile along with additional information for Susan Dominguez, a provider established in Berkeley, California with a medical specialization in Psychologist, focusing in intellectual and developmental disabilities . The healthcare provider is registered in the NPI registry with number 1477709483 assigned on August 2008. The practitioner's primary taxonomy code is 103TM1800X with license number PSY24264 (CA). The provider is registered as an individual and her NPI record was last updated February 2026.
- NPI
- 1477709483
- Provider Name
- MRS. SUSAN DOMINGUEZ PSY24264
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3200 ADELINE ST BERKELEY, CA 94703
- Location Phone
- (510) 601-0203
- Location Fax
- (510) 601-4002
- Mailing Address
- 6010 HIGHWAY 9 STE 7 FELTON, CA 95018
- Mailing Phone
- (831) 515-6817
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-09-2008
- Last Update Date
- 02-04-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Intellectual and Developmental Disabilities
- Taxonomy Code
- 103TM1800X
- Type
- Behavioral Health & Social Service Providers
- License No.
- PSY24264
- License State
- CA
Medicare Participation & PECOS Enrollment Status
Susan Dominguez is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for MRS. SUSAN DOMINGUEZ PSY24264
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1477709483, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 19 providers are registered at the same or a nearby location.
BERKELEY, CA 94703
BERKELEY, CA 94703
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477709483, enumerated as an "individual" on August 09, 2008.
The provider is located at 3200 ADELINE ST BERKELEY, CA 94703 and the phone number is (510) 601-0203.
Psychologist with taxonomy code 103TM1800X and a focus in Intellectual and Developmental Disabilities.
