Provider Demographics
NPI:1326190745
Name:KAY, DOMONIC L (MFT)
Entity type:Individual
Prefix:MS
First Name:DOMONIC
Middle Name:L
Last Name:KAY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 HONEY RUN CT
Mailing Address - Street 2:
Mailing Address - City:PLUMAS LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95961
Mailing Address - Country:US
Mailing Address - Phone:830-742-7315
Mailing Address - Fax:830-742-7315
Practice Address - Street 1:10725 INTERNATIONAL DR
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670
Practice Address - Country:US
Practice Address - Phone:916-631-2406
Practice Address - Fax:916-631-2439
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM22997106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist