Provider Demographics
NPI:1548060114
Name:CIANFICHI, DOMINIQUE JEAN
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:JEAN
Last Name:CIANFICHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 RANCH ROAD 620 N APT 5112
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734-2843
Mailing Address - Country:US
Mailing Address - Phone:925-759-4862
Mailing Address - Fax:
Practice Address - Street 1:4201 W PARMER LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-4109
Practice Address - Country:US
Practice Address - Phone:737-241-2271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059386163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health