MR. JEB M BURNS (NPI# 1104856624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104856624 |
| Entity Type | Individual |
| Full Name | MR. JEB M BURNS |
| Credential | ATC |
| Practice Address |
One Washington Square San Jose CA 95192-0001 |
| Mailing Address |
4872 Speak Ln San Jose CA 95118-3712 |
| Practice Telephone | 4089241256 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
ONE WASHINGTON SQUARE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95192-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306313085 | Masaaki Tsuruike | Preventive Medicine | One Washington Square, San Jose, CA 95192-0054 | 2018-10-31 |
| 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 |
| 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 |
| 1144361338 | Erin M Coleman | Specialist/Technologist | 1 Washington Sq, San Jose, CA 95192-0001 | 2007-02-09 |
| 1679679179 | Scott Lieberman | Radiology | 1 Washington Sq, Ste Hb103, San Jose, CA 95192-0001 | 2006-09-15 |
| 1639203755 | Harry John Cornbleet | Internal Medicine | San Jose State University Student Health Ctr, 1 Washington Sq, San Jose, CA 95192-0037 | 2007-03-14 |
| 1457534968 | San Jose State University Student Health Center | Clinic/Center | 1 Washington Sq, San Jose, CA 95192-0037 | 2007-12-07 |
| 1124230008 | Robert Laurence Kronisch | Family Medicine | San Jose State University Student Health Ctr, One Washington Square, San Jose, CA 95192-0037 | 2007-05-04 |
| 1295952711 | Nancy Marie Nuzzolillo | Nurse Practitioner | 1 Washington Sq, San Jose, CA 95192-0037 | 2007-04-18 |
| Find all providers in zip 95192 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093326324 | Kyungmo Han | Specialist/Technologist | Department of Kinesiology One Washington Square, San Jose, CA 95192-0001 | 2020-08-11 |
| 1518587021 | Scott Allen Zimmerman | Specialist/Technologist | 5000 Mitty Way, San Jose, CA 95129-1868 | 2020-04-24 |
| 1407406788 | Binh Hung Ton-that | Specialist/Technologist | 4198 Gion Ave, San Jose, CA 95127-1908 | 2019-09-18 |
| 1184279226 | Tanner Fowler | Specialist/Technologist | 1306 The Alameda Apt 221, San Jose, CA 95126-5014 | 2019-08-06 |
| 1447804521 | Michael Tai Tang | Specialist/Technologist | 424 S 7th St, San Jose, CA 95112-3809 | 2019-07-28 |
| 1376001784 | Wilson Hsieh | Specialist/Technologist | 4648 Park Milford Pl, San Jose, CA 95136-2521 | 2019-03-05 |
| 1376012948 | Theresa Ortiz | Specialist/Technologist | 796 Amanda Dr, San Jose, CA 95136-1909 | 2018-11-13 |
| 1073091625 | Rachel Ann Vaccaro | Specialist/Technologist | 1539 Hervey Ln, San Jose, CA 95125-1849 | 2018-08-04 |
| 1063909190 | Mayuresh Nandkeolyar | Specialist/Technologist | 5460 Don Diablo Ct, San Jose, CA 95123-3113 | 2018-04-14 |
| 1164929873 | Catherine English | Specialist/Technologist | 850 The Alameda Ste 20, San Jose, CA 95126-3146 | 2018-04-09 |
| Find all providers in SAN JOSE | ||||
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| 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.