SAN JOSE STATE UNIVERSITY STUDENT HEALTH CENTER (NPI# 1457534968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457534968 |
Entity Type | Organization |
Organization Name | SAN JOSE STATE UNIVERSITY STUDENT HEALTH CENTER |
Practice Address |
1 Washington Sq San Jose CA 95192-0037 |
Practice Telephone | 4089246120 |
Practice Fax Number | 4089247786 |
Mailing Telephone | 4089246120 |
Mailing Fax Number | 4089247786 |
Enumeration Date | 2007-12-07 |
Last Update Date | 2007-12-07 |
Authorized Official Name | DR. CECILIA MANIBO (MEDICAL CHIEF OF STAFF) |
Authorized Official Telephone | 4089246140 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | CALIFORNIA STATE UNIVERSITY |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDI-CAL PROVIDER NUMBER | GR0051700 | 01 |
Street Address |
1 WASHINGTON SQ |
City | SAN JOSE |
State | CA |
Zip Code | 95192-0037 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144869223 | Claire Foster | Psychologist | 1 Washington Sq, San Jose, CA 95192-1112 | 2020-01-06 |
1417433657 | Peitzu Tsai | Speech-Language Pathologist | 1 Washington Sq, San Jose, CA 95192-0079 | 2018-07-11 |
1528554839 | Gina Marie Guglielmoni | Specialist/Technologist | 1 Washington Sq, San Jose, CA 95192-1000 | 2018-07-10 |
1780109330 | Lisa Anne Palmer | Student in an Organized Health Care Education/Training Program | 1 Washington Sq, San Jose, CA 95192-1000 | 2017-08-04 |
1508215906 | Samantha Calvet | Specialist/Technologist | 1 Washington Sq, San Jose, CA 95192-1000 | 2016-06-07 |
1881948560 | Erin L Woodhead | Psychologist | 1 Washington Sq, San Jose, CA 95192-0120 | 2012-11-02 |
1740562065 | Marcella Mccollum | Speech-Language Pathologist | 1 Washington Sq, Sh 115, San Jose, CA 95192-0079 | 2011-09-13 |
1225310444 | Wendy Quach | Speech-Language Pathologist | 1 Washington Sq, San Jose, CA 95192-0079 | 2011-09-13 |
1912151382 | Amy L. Moore | Registered Nurse | 1 Washington Sq, San Jose, CA 95192-3613 | 2008-11-11 |
1295952711 | Nancy Marie Nuzzolillo | Nurse Practitioner | 1 Washington Sq, San Jose, CA 95192-0037 | 2007-04-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093326324 | Kyungmo Han | Specialist/Technologist | Department of Kinesiology One Washington Square, San Jose, CA 95192-0001 | 2020-08-11 |
1558589382 | Barbara Fu | Internal Medicine | Sjsu Shc One Washington Sq, San Jose, CA 95192-0001 | 2007-04-24 |
1104856624 | Jeb M Burns | Specialist/Technologist | One Washington Square, San Jose, CA 95192-0001 | 2006-07-03 |
1598702136 | Jeffrey James Roberts | Specialist/Technologist | San Jose State University, Department of Kinesiology, San Jose, CA 95192-0001 | 2006-06-01 |
1013246628 | Roger Karlsson | Psychologist | Department of Psychology, 1 Washington Sq, San Jose, CA 95192-0001 | 2009-12-09 |
1639203755 | Harry John Cornbleet | Internal Medicine | San Jose State University Student Health Ctr, 1 Washington Sq, San Jose, CA 95192-0037 | 2007-03-14 |
1124230008 | Robert Laurence Kronisch | Family Medicine | San Jose State University Student Health Ctr, One Washington Square, San Jose, CA 95192-0037 | 2007-05-04 |
1306313085 | Masaaki Tsuruike | Preventive Medicine | One Washington Square, San Jose, CA 95192-0054 | 2018-10-31 |
1013180488 | Jennifer Gregg | Psychologist | Dept of Psychology, One Washington Square, San Jose, CA 95192-0120 | 2008-04-08 |
1407136872 | Jenessa Bayda | Social Worker | School of Social Work, One Washington Square, San Jose, CA 95192-0124 | 2011-08-17 |
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Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558974097 | Jiseki Health Inc | Clinic/Center | 1150 S King Rd Ste 40, San Jose, CA 95122-2140 | 2020-08-25 |
1568082907 | A&m Acupuncture Health Center | Clinic/Center | 2680 Cropley Ave, San Jose, CA 95132-3711 | 2020-04-24 |
1912552688 | Acuherb Medical Group | Clinic/Center | 999 Saratoga Ave Ste 30, San Jose, CA 95129-2300 | 2019-08-08 |
1669033320 | Insightmd, Inc. | Clinic/Center | 333 W San Carlos St Ste 600, San Jose, CA 95110-2731 | 2019-06-24 |
1427525682 | American Current Care of California, A Medical Corporation | Clinic/Center | 1887 Monterey Hwy Ste 200, San Jose, CA 95112-6192 | 2018-10-25 |
1740777028 | Ontrack Therapy Services P.C. | Clinic/Center | 4850 Pearl Ave, San Jose, CA 95136-2701 | 2018-04-22 |
1528599842 | Miracle Wands Clinic | Clinic/Center | 1143 Story Rd Ste 250&260, San Jose, CA 95122-2610 | 2017-03-27 |
1629523543 | Longspringhealthcenter | Clinic/Center | 1189 S De Anza Blvd Ste B, San Jose, CA 95129-3662 | 2016-08-21 |
1497122063 | Laughing Giraffe Therapy Inc | Clinic/Center | 100 Oconnor Dr Ste 14, San Jose, CA 95128-1638 | 2015-08-29 |
1558754416 | South Bay Paediatrics | Clinic/Center | 1671 Ridgetree Way, San Jose, CA 95131-1944 | 2015-03-16 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.