SAN JOSE STATE UNIVERSITY STUDENT HEALTH CENTER


Address: 1 Washington Sq, San Jose, CA 95192-0037
Phone: 4089246120

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA MEDI-CAL PROVIDER NUMBER GR0051700 01

Office Location

Street Address 1 WASHINGTON SQ
City SAN JOSE
State CA
Zip Code 95192-0037

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

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).

Providers in the same taxonomy and city

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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Competitor

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City SAN JOSE
Zip Code 95192

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Dataset Information

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.

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