Active NPI
Tyreina Benisha Amey, PTA
- Physical Therapy Assistant
- Stockton, CA
National Provider Identifier
1104129857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TA9317
- Practice address
- 1429 W Fremont St
Stockton, CA 95203-2635 - Phone
- (209) 546-0944
- NPI assigned
- Dec 17, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TA9317 | CA | Primary |
Addresses
Primary practice location
1429 W Fremont St
Stockton, CA 95203-2635
Mailing address
1601 Hood Road
Apt 21
Sacramento, CA 95825-8419
Phone (510) 213-4141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA9317 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292544000000",
"number": "1104129857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 HOOD ROAD",
"address_2": "APT 21",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958258419",
"telephone_number": "510-213-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1429 W FREMONT ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952032635",
"telephone_number": "209-546-0944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMEY",
"first_name": "TYREINA",
"middle_name": "BENISHA",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-17",
"last_updated": "2010-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "TA9317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.