Healthcare Provider Details

I. General information

NPI: 1124978937
Provider Name (Legal Business Name): OPTIMAL MOTION DYNAMICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11721 FAIR OAKS BLVD
FAIR OAKS CA
95628-2816
US

IV. Provider business mailing address

11721 FAIR OAKS BLVD
FAIR OAKS CA
95628-2816
US

V. Phone/Fax

Practice location:
  • Phone: 916-616-5669
  • Fax:
Mailing address:
  • Phone: 916-616-5669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: LEAH JONES
Title or Position: STRETCH PRACTITIONER
Credential:
Phone: 916-667-5100