Individual provider Active NPI

Reynaldo Amaya

  • Community Health Worker
  • Fresno, CA
National Provider Identifier
1609562404
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
4141 N Blackstone Ave
Fresno, CA 93726-3808
Phone
(559) 710-0175
NPI assigned
Apr 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

4141 N Blackstone Ave
Fresno, CA 93726-3808

Mailing address

2235 W Simpson Ave
Fresno, CA 93705-3632
Phone (559) 710-0175

Other practice location 1

2719 N Air Fresno Dr
Fresno, CA 93727-1547
Phone (559) 600-9180

Other practice location 2

4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 600-9180

Other practice location 3

4468 E Kings Canyon Rd
Fresno, CA 93702-3605
Phone (559) 977-0295

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

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1609562404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 W SIMPSON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937053632",
            "telephone_number": "559-710-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937263808",
            "telephone_number": "559-710-0175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2719 N Air Fresno Dr",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271547",
            "country_code": "US",
            "telephone_number": "559-600-9180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4441 E Kings Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-600-9180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4468 E Kings Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023605",
            "country_code": "US",
            "telephone_number": "559-977-0295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMAYA",
        "first_name": "REYNALDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-14",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.