Individual provider Active NPI

Lynnette Yamamoto, PT, DPT

  • Pediatric Physical Therapist
  • Anaheim, CA
National Provider Identifier
1205203700
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT42835 Issued in CA
Practice address
217 W Cerritos Ave
Anaheim, CA 92805-6549
Phone
(714) 776-1231
Fax
(714) 776-0802
NPI assigned
Aug 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT42835 CA Primary

Addresses

Primary practice location

217 W Cerritos Ave
Anaheim, CA 92805-6549

Mailing address

217 W Cerritos Ave
Anaheim, CA 92805-6549
Phone (714) 776-1231

Other practice location 1

50 E Foothill Blvd Ste 100
Arcadia, CA 91006-2314
Phone (626) 445-2400

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

LicenseStateTypeSpecialty
PT42835CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Therapies, Inc. Pediatrics PastSince May 30, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1205203700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W CERRITOS AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056549",
            "telephone_number": "714-776-1231",
            "fax_number": "714-776-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CERRITOS AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928056549",
            "telephone_number": "714-776-1231",
            "fax_number": "714-776-0802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 E Foothill Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910062314",
            "country_code": "US",
            "telephone_number": "626-445-2400",
            "fax_number": "626-445-2419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "LYNNETTE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT42835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.