Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | 408141-00 | CA |
N | 226300000X | Kinesiotherapist | 1566 | CA |
NPI | 1063529436 |
---|---|
Provider Name | Ms. Janian Kaye Thurman |
First Address | San Diego, CA 92109-3433 |
Second Address | San Diego, CA 92182-7251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |