Dianne Marie Fong Reyes, BACHELORS DEGREE

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

10427 Issued in CA

Practice address

1717 S Main St
Milpitas, CA 95035-6756

Phone

(409) 957-5700

NPI assigned

May 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Dianne Marie Gutierrez Fong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1992116362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 DEMPSEY RD UNIT 135",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950355675",
            "telephone_number": "415-465-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S MAIN ST",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950356756",
            "telephone_number": "409-957-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "DIANNE MARIE",
        "middle_name": "FONG",
        "name_prefix": "Mrs.",
        "credential": "BACHELORS DEGREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10427",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008915",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "10427",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNE MARIE",
            "last_name": "FONG",
            "middle_name": "GUTIERREZ",
            "prefix": "MISS",
            "credential": "BACHELORS DEGREE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Relief Home Health, LLC
• Namasann Reth
• Revervale Psychotherapy PC
• Amnesty Reyes Reyes-Bueno
• Adrian Reyes
• Fernan San Juan Reyes, MT
• Nate Reyes
• Esther Rhee, DMD
• Adrian Ricalde, DC
• Richard H Duong, D.D.S.

• Physical Therapy Assistant in Milpitas, CA
• Providers in Milpitas, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.