Active NPI
Pamela Hannah Tena Diezmo, PT
- Physical Therapist
- Moreno Valley, CA
National Provider Identifier
1881159671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT42486
- Practice address
- 16611 War Cloud Dr
Moreno Valley, CA 92551-2584 - Phone
- (949) 632-4674
- Fax
- (951) 807-3505
- NPI assigned
- Feb 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT42486 | CA | Primary |
Addresses
Primary practice location
16611 War Cloud Dr
Moreno Valley, CA 92551-2584
Mailing address
16611 War Cloud Dr
Moreno Valley, CA 92551-2584
Phone (949) 632-4674
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT42486 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feld Care Therapy Inc | Physical Therapist | Past | 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.
-
- Physical Therapist
- Tampa, FL
- NPI 1134075864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549324800000",
"number": "1881159671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16611 WAR CLOUD DR",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925512584",
"telephone_number": "949-632-4674",
"fax_number": "951-807-3505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16611 WAR CLOUD DR",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925512584",
"telephone_number": "949-632-4674",
"fax_number": "951-807-3505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEZMO",
"first_name": "PAMELA HANNAH",
"middle_name": "TENA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-05",
"last_updated": "2019-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT42486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.