Proactive Physical Therapy and Fitness

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

37257 Issued in CA

Legal business name

PROACTIVE PHYSICAL THERAPY AND FITNESS

Practice address

39420 Liberty St
Suite 173a
Fremont, CA 94538-2200

Phone

(510) 358-2071

Fax

(510) 358-2248

NPI assigned

Aug 11, 2014

Organization subpart

No

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

Authorized official

Name

Genaro Jimenez, PTNPI 1457649618

Title

Owner

Phone

(510) 358-2071

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Genaro Aral Jimenez, PT

  • Physical Therapist
  • Fremont, CA
  • NPI 1457649618
  NPD (past) Authorized official

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1609285956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST",
            "address_2": "SUITE 173A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382200",
            "telephone_number": "510-358-2071",
            "fax_number": "510-358-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39420 LIBERTY ST",
            "address_2": "SUITE 173A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382200",
            "telephone_number": "510-358-2071",
            "fax_number": "510-358-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY AND FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "GENARO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-358-2071",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Fremont, CA
• Providers in Fremont, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.