Optimotion Physical Therapy Sport and Spine, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

30188 Issued in CA

Legal business name

OPTIMOTION PHYSICAL THERAPY SPORT AND SPINE, INC.

Practice address

1736 Picasso Ave
Suite a
Davis, CA 95618-0558

Phone

(530) 867-6679

NPI assigned

Jun 26, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Amy Ling Fong, PT, DPT, OCS, SCS

Title

President

Phone

(530) 867-6679

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1497137384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 PICASSO AVE",
            "address_2": "SUITE A",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956180558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 PICASSO AVE",
            "address_2": "SUITE A",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956180558",
            "telephone_number": "530-867-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMOTION PHYSICAL THERAPY SPORT AND SPINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-867-6679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS, SCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "30188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamal Lewis Oney
• Danielle Onn
• Reyn K Ono, PHARM.D.
• Onsite Medical Service
• Andrew R Opfell, MD
• Thomas W Ormiston, MD
• Veronica Oropeza, RN
• Ana Cecilia Orozco, MD
• Elena Orozco
• Jacquelina Orozco

• Physical Therapy Clinic/Center in Davis, CA
• Providers in Davis, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.