NPIMap

Organization Active NPI

San Jose State University Student Health Center

  • Clinic/Center
  • San Jose, CA
National Provider Identifier
1457534968
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAN JOSE STATE UNIVERSITY STUDENT HEALTH CENTER
Practice address
1 Washington SQ
San Jose, CA 95192-0037
Phone
(408) 924-6120
Fax
(408) 924-7786
NPI assigned
Dec 7, 2007
Organization subpart
Yes
Parent organization
CALIFORNIA STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Dr. Cecilia Manibo, M.D.NPI 1770616922
Title
Medical Chief of Staff
Phone
(408) 924-6140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1 Washington SQ
San Jose, CA 95192-0037

Mailing address

1 Washington SQ
San Jose, CA 95192-0037
Phone (408) 924-6120

Other identifiers 1

IdentifierTypeStateIssuer
GR0051700OtherCAMEDI-CAL PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
State of California Prison Industry Authority30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

1 Washington Sq
San Jose, CA 95192
Phone (408) 924-5678

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1457534968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON SQ",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951920037",
            "telephone_number": "408-924-6120",
            "fax_number": "408-924-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON SQ",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951920037",
            "telephone_number": "408-924-6120",
            "fax_number": "408-924-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE STATE UNIVERSITY STUDENT HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALIFORNIA STATE UNIVERSITY",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "MANIBO",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "MEDICAL CHIEF OF STAFF",
        "authorized_official_telephone_number": "408-924-6140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NUMBER",
            "identifier": "GR0051700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.