Individual provider Active NPI

Jennifer Chiu, CCP

  • Perfusionist
  • Burlingame, CA
National Provider Identifier
1881811305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
License
059017 Issued in CA
Practice address
1405 Oak Grove Ave
Apt. 306
Burlingame, CA 94010-3775
Phone
(650) 815-1921
Fax
(650) 615-9995
NPI assigned
Apr 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X 059017 CA Primary

Addresses

Primary practice location

1405 Oak Grove Ave
Apt. 306
Burlingame, CA 94010-3775

Mailing address

1405 Oak Grove Ave
Apt. 306
Burlingame, CA 94010-3775
Phone (650) 815-1921

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
059017CAMDPerfusionist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881811305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 OAK GROVE AVE",
            "address_2": "APT. 306",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103775",
            "telephone_number": "650-815-1921",
            "fax_number": "650-615-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 OAK GROVE AVE",
            "address_2": "APT. 306",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103775",
            "telephone_number": "650-815-1921",
            "fax_number": "650-615-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "JENNIFER",
        "credential": "CCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "CA",
            "license": "059017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.