Individual provider Active NPI

Aimee Jayne Tijerina, PT

  • Pediatric Physical Therapist
  • Fresno, CA
National Provider Identifier
1669530721
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT25969 Issued in CA
Practice address
7638 N Ingram Ave Ste 105
Fresno, CA 93711-6203
Phone
(559) 433-4700
Fax
(559) 234-1440
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25969 CA
Pediatric Physical Therapist 2251P0200X PT25969 CA Primary

Addresses

Primary practice location

7638 N Ingram Ave Ste 105
Fresno, CA 93711-6203

Mailing address

9911 N Granville Ave
Fresno, CA 93720-4255
Phone (559) 433-4700

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

State licenses

LicenseStateTypeSpecialty
PT25969CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Kids, Inc. PastSince Mar 19, 2023 Accepting new patients

Organizations & group practices 1

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1669530721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 N GRANVILLE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204255",
            "telephone_number": "559-433-4700",
            "fax_number": "559-234-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7638 N INGRAM AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116203",
            "telephone_number": "559-433-4700",
            "fax_number": "559-234-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIJERINA",
        "first_name": "AIMEE",
        "middle_name": "JAYNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25969",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT25969",
            "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 Mar 14, 2023; 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.