Individual provider Active NPI

Cecilia O Amajoyi Agunenye, PA

  • Physician Assistant
  • Rancho Cucamonga, CA
National Provider Identifier
1710180260
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55699 Issued in CA
Practice address
8160 Day Creek Blvd Unit 120
Rancho Cucamonga, CA 91739-9329
Phone
(909) 825-7084
NPI assigned
Jun 11, 2007
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA895 TN
Physician Assistant 363A00000X PA55699 CA Primary

Addresses

Primary practice location

8160 Day Creek Blvd Unit 120
Rancho Cucamonga, CA 91739-9329

Mailing address

1068 Cresthaven Rd 300
Memphis, TN 38119-0809
Phone (901) 683-0024

Other practice location 1

255 E Bonita Ave
Pomona, CA 91767-1923
Phone (909) 643-2980

Other identifiers 2

IdentifierTypeStateIssuer
PA895OtherTNSTATE LICENSE
PA55699OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041103000306 TN Practitioner - Physician Assistant 1759343502 Reassigns benefits to 2 organizations
I20180816001751 CA Practitioner - Physician Assistant 1759343502 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

12442 Limonite Ave
Unit 102
Eastvale, CA 91752-2467
Phone (951) 393-3000

16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242
Phone (909) 434-1150

245 Terracina Blvd
Suite 102
Redlands, CA 92373-4865
Phone (909) 406-2671

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

420 W Rowland St
Suite 101
Covina, CA 91723-2943
Phone (626) 412-2614

7000 Boulder Ave
Suite 103
Highland, CA 92346-3348
Phone (515) 441-6271

7777 Milliken Ave
Suite a
Rancho Cucamonga, CA 91730-7489
Phone (909) 466-0909

839 Highland Springs Ave
Suite 101
Beaumont, CA 92223-5767
Phone (951) 521-1580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55699CAMDOrthodontics and Dentofacial Orthopedic Dentist
PA55699CAMDPhysician Assistant
PA895TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2017 Accepting new patients
Ut Medical Group, Inc. CurrentSince May 1, 2011 Accepting new patients
Mountain View Urgent Care Group, Inc CurrentSince Jul 1, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2017 Accepting new patients
Firstcare Medical Center, PC Past Accepting new patients
Eastside Medical Center Past Accepting new patients
Hardeman County Community Health Center Past Accepting new patients

Locations

12442 Limonite Ave
Unit 102
Eastvale, CA 91752
Phone (951) 393-3000

16465 Sierra Lakes Pkwy
Ste 100
Fontana, CA 92336
Phone (909) 434-1150

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18095/brand/2/csg/1/fhir/r4

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1710180260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809",
            "telephone_number": "901-683-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8160 DAY CREEK BLVD UNIT 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399329",
            "telephone_number": "909-825-7084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 E Bonita Ave",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671923",
            "country_code": "US",
            "telephone_number": "909-643-2980",
            "fax_number": "909-596-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMAJOYI AGUNENYE",
        "first_name": "CECILIA",
        "middle_name": "O",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA895",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA895",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA55699",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.