Individual ProviderJoel DominguezMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address4050 Katella Ave, Suite 102, Los Alamitos, CA 90720-3434(562) 260-9058PECOS EnrollmentBased on the most recent information from CMS, provider Joel Dominguez is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1487902433Provider TypeIndividualFull NameDominguez, JoelCredentialM.A., MFTGenderMaleSole ProprietorYesEnumeration Date8/23/2012Last Updated11/23/2016Contact InformationPractice LocationPractice Address4050 Katella Ave, Suite 102, Los Alamitos, CA 90720-3434Phone(562) 260-9058FaxUnlisted FaxMailing LocationMailing Address1604 Crescent Heights St, Signal Hill, CA 90755-3602Phone(562) 260-9058FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC52052California