NPIMap

Organization Active NPI

Dynamic Kids, Inc.

  • Physical Therapy Clinic/Center
  • Clovis, CA
National Provider Identifier
1124239363
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT25969 Issued in CA
Legal business name
DYNAMIC KIDS, INC.
Practice address
755 N Peach Ave Ste G14
Clovis, CA 93611-7247
Phone
(559) 433-4700
Fax
(559) 234-1440
NPI assigned
May 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Aimee Jayne Tijerina, P.T.NPI 1669530721
Title
Director, Physical Therapist
Phone
(559) 433-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT25969 CA Primary

Addresses

Primary practice location

755 N Peach Ave Ste G14
Clovis, CA 93611-7247

Mailing address

755 N Peach Ave Ste G14
Clovis, CA 93611-7247
Phone (559) 433-4700

Other names 1

  • Dynamic Kids Pediatric Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

755 N Peach Ave
Ste G14
Clovis, CA 93611
Phone (559) 433-4700

7638 N Ingram Ave
Ste 105
Fresno, CA 93711
Phone (559) 433-4700

1360 E Spruce Ave
Ste 103
Fresno, CA 93720
Phone (559) 433-4700

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124239363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N PEACH AVE STE G14",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936117247",
            "telephone_number": "559-433-4700",
            "fax_number": "559-234-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N PEACH AVE STE G14",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936117247",
            "telephone_number": "559-433-4700",
            "fax_number": "559-234-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC KIDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIJERINA",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_middle_name": "JAYNE",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "559-433-4700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT25969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Kids Pediatric Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.