Individual provider Active NPI

Cynthia M Guillett, DC

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1669433553
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0143840 Issued in CA
Practice address
1711 Branham LN
Suite A12
San Jose, CA 95118-5224
Phone
(408) 269-7111
Fax
(408) 269-7110
NPI assigned
Mar 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0143840 CA Primary

Addresses

Primary practice location

1711 Branham LN
Suite A12
San Jose, CA 95118-5224

Mailing address

1711 Branham LN
Suite A12
San Jose, CA 95118-5224
Phone (408) 269-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0143840CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wong Momentum Chiropractic Corp Chiropractor CurrentSince May 28, 2023 Accepting new patients
Carl F Dieter a Professional Chiropractic Corp Chiropractor PastSince Jan 10, 2020 Accepting new patients

Locations

1711 Branham Ln
Ste A12
San Jose, CA 95118
Phone (408) 269-7111

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1669433553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 BRANHAM LN",
            "address_2": "SUITE A12",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951185224",
            "telephone_number": "408-269-7111",
            "fax_number": "408-269-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 BRANHAM LN",
            "address_2": "SUITE A12",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951185224",
            "telephone_number": "408-269-7111",
            "fax_number": "408-269-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLETT",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-30",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0143840",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 28, 2014; 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.