Active NPI
Courtney Proen, PT, DPT
- Physical Therapist
- Fresno, CA
National Provider Identifier
1902270127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 43400
- Practice address
- 1903 E Fir Ave
#102
Fresno, CA 93720-3862 - Phone
- (559) 322-1703
- NPI assigned
- Nov 26, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 43400 | CA | Primary |
Addresses
Primary practice location
1903 E Fir Ave
#102
Fresno, CA 93720-3862
Mailing address
1903 E Fir Ave
#102
Fresno, CA 93720-3862
Phone (559) 322-1703
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1902270127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1903 E FIR AVE",
"address_2": "#102",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203862",
"telephone_number": "559-322-1703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1903 E FIR AVE",
"address_2": "#102",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203862",
"telephone_number": "559-322-1703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROEN",
"first_name": "COURTNEY",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-26",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "43400",
"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 15, 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.