Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jared Domaguing

Individual provider Nurse Practitioner · NPI 1609657741

Jared Domaguing is a Nurse Practitioner in Walnut Creek, California. Qualified in 2023, 3 years ago. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023

Practice location Address checks out

450 N Wiget Ln
Walnut Creek, CA 94598-2408
Phone: (510) 690-7357
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95027588 (CA)

Record details

NPI number1609657741
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 12, 2023
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023
Mailing address57 Ben Lomond, Hercules, CA 94547-3940

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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