Individual provider Active NPI

Jessica Lizama

  • Physical Therapist
  • Upland, CA
National Provider Identifier
1710802780
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
310265 Issued in CA
Practice address
2377 W Foothill Blvd Ste 20
Upland, CA 91786-3584
Phone
(909) 608-2800
NPI assigned
Aug 11, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 310265 CA Primary

Addresses

Primary practice location

2377 W Foothill Blvd Ste 20
Upland, CA 91786-3584

Mailing address

2377 W Foothill Blvd Ste 20
Upland, CA 91786-3584

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Performance Physical Therapy Inc Physical Therapist PastSince Sep 1, 2017 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": "1786406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1710802780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 W FOOTHILL BLVD STE 20",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 W FOOTHILL BLVD STE 20",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863584",
            "telephone_number": "909-608-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZAMA",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-08-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "310265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.