Individual provider Active NPI

Titianna Little, PT, DPT

  • Physical Therapist
  • Yucaipa, CA
National Provider Identifier
1336659861
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501018377 Issued in MI
Practice address
32819 Yucaipa Boulevard #3
Yucaipa, CA 92399
Phone
(909) 797-9010
Fax
(909) 797-9046
NPI assigned
Oct 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501018377 MI Primary

Addresses

Primary practice location

32819 Yucaipa Boulevard #3
Yucaipa, CA 92399

Mailing address

32819 Yucaipa Boulevard #3
Yucaipa, CA 92399
Phone (909) 797-9010

Other names 1

  • Titianna Dunn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180312002274 CA Practitioner - Physical Therapist in Private Practice 4183986094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adorador Enterprises IncGroup PAC ID 4183651276, 7 clinicians

Practice addresses (Care Compare)

1676 E 6TH St
Suite C
Beaumont, CA 92223-5760
Phone (951) 769-0300

34213 Yucaipa Blvd
Suite a
Yucaipa, CA 92399-2494
Phone (909) 797-9010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501018377MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Nov 28, 2022 Accepting new patients
Michael R Gurk Ms PT Apc Physical Therapist PastSince Dec 1, 2017 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

Organizations & group practices 3

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": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1336659861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32819 YUCAIPA BOULEVARD #3",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-797-9010",
            "fax_number": "909-797-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32819 YUCAIPA BOULEVARD #3",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "92399",
            "telephone_number": "909-797-9010",
            "fax_number": "909-797-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "TITIANNA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TITIANNA",
            "last_name": "DUNN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.