Individual provider Active NPI

Amanda Nicole Brandenburg

  • Physical Therapy Assistant
  • Riverside, CA
National Provider Identifier
1205731791
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
54925 Issued in CA
Practice address
4300 Central Ave
Riverside, CA 92506-2918
Phone
(951) 222-2206
NPI assigned
Oct 13, 2026
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 54925 CA Primary

Addresses

Primary practice location

4300 Central Ave
Riverside, CA 92506-2918

Mailing address

4300 Central Ave
Riverside, CA 92506-2918
Phone (951) 222-2206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1205731791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062918",
            "telephone_number": "951-222-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 CENTRAL AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062918",
            "telephone_number": "951-222-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-13",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "54925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.