Provider Demographics
NPI:1669530721
Name:TIJERINA, AIMEE JAYNE (PT)
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:JAYNE
Last Name:TIJERINA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9911 N GRANVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4255
Mailing Address - Country:US
Mailing Address - Phone:559-433-4700
Mailing Address - Fax:559-234-1440
Practice Address - Street 1:7638 N INGRAM AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-6203
Practice Address - Country:US
Practice Address - Phone:559-433-4700
Practice Address - Fax:559-234-1440
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25969225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist