DR. CECILIA L. MANIBO (NPI# 1770616922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770616922 |
| Entity Type | Individual |
| Full Name | DR. CECILIA L. MANIBO |
| Credential | M.D. |
| Practice Address |
1 Washington Sq San Jose CA 95192-0037 |
| Mailing Address |
2040 Spanish Bay Ct San Jose CA 95138-2106 |
| Practice Telephone | 4089246140 |
| Practice Fax Number | 4089246104 |
| Mailing Telephone | 4082237189 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G69758 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1 WASHINGTON SQ |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95192-0037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144869223 | Claire Foster | Psychologist | 1 Washington Sq, San Jose, CA 95192-1112 | 2020-01-06 |
| 1417433657 | Peitzu Tsai | Speech-Language Pathologist | 1 Washington Sq, San Jose, CA 95192-0079 | 2018-07-11 |
| 1528554839 | Gina Marie Guglielmoni | Specialist/Technologist | 1 Washington Sq, San Jose, CA 95192-1000 | 2018-07-10 |
| 1780109330 | Lisa Anne Palmer | Student in an Organized Health Care Education/Training Program | 1 Washington Sq, San Jose, CA 95192-1000 | 2017-08-04 |
| 1508215906 | Samantha Calvet | Specialist/Technologist | 1 Washington Sq, San Jose, CA 95192-1000 | 2016-06-07 |
| 1881948560 | Erin L Woodhead | Psychologist | 1 Washington Sq, San Jose, CA 95192-0120 | 2012-11-02 |
| 1740562065 | Marcella Mccollum | Speech-Language Pathologist | 1 Washington Sq, Sh 115, San Jose, CA 95192-0079 | 2011-09-13 |
| 1225310444 | Wendy Quach | Speech-Language Pathologist | 1 Washington Sq, San Jose, CA 95192-0079 | 2011-09-13 |
| 1912151382 | Amy L. Moore | Registered Nurse | 1 Washington Sq, San Jose, CA 95192-3613 | 2008-11-11 |
| 1457534968 | San Jose State University Student Health Center | Clinic/Center | 1 Washington Sq, San Jose, CA 95192-0037 | 2007-12-07 |
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| 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 |
| 1104856624 | Jeb M Burns | Specialist/Technologist | One Washington Square, San Jose, CA 95192-0001 | 2006-07-03 |
| 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 |
| 1639203755 | Harry John Cornbleet | Internal Medicine | San Jose State University Student Health Ctr, 1 Washington Sq, San Jose, CA 95192-0037 | 2007-03-14 |
| 1124230008 | Robert Laurence Kronisch | Family Medicine | San Jose State University Student Health Ctr, One Washington Square, San Jose, CA 95192-0037 | 2007-05-04 |
| 1306313085 | Masaaki Tsuruike | Preventive Medicine | One Washington Square, San Jose, CA 95192-0054 | 2018-10-31 |
| 1013180488 | Jennifer Gregg | Psychologist | Dept of Psychology, One Washington Square, San Jose, CA 95192-0120 | 2008-04-08 |
| 1407136872 | Jenessa Bayda | Social Worker | School of Social Work, One Washington Square, San Jose, CA 95192-0124 | 2011-08-17 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922658723 | Mai Medical, Inc. | Family Medicine | 2641 Senter Rd, San Jose, CA 95111-1122 | 2019-09-13 |
| 1740712421 | Emily Hsiao | Family Medicine | 276 International Cir Unit D, San Jose, CA 95119-1130 | 2017-03-31 |
| 1629526264 | John Heringer | Family Medicine | 2823 Cardinal Ln, San Jose, CA 95125-4800 | 2016-09-12 |
| 1598152043 | Shoaib Khalid | Family Medicine | 6658 Mount Holly Dr, San Jose, CA 95120-1931 | 2015-04-22 |
| 1942604665 | Kyaw Min | Family Medicine | 2395 Montpelier Dr Ste 4, San Jose, CA 95116-1619 | 2014-10-09 |
| 1679996151 | Qingbo Sui | Family Medicine | 1870 Lundy Avenue, San Jose, CA 95131-1826 | 2014-02-04 |
| 1972938801 | Claudine Lott | Family Medicine | 145 Nicholson Ln, San Jose, CA 95134 | 2013-09-11 |
| 1689016271 | Valerie Halls | Family Medicine | 276 International Cir Unit G, San Jose, CA 95119-1130 | 2013-07-23 |
| 1114366572 | Maryam Kalami | Family Medicine | 1451 Regalo Ct, San Jose, CA 95128-4523 | 2013-06-19 |
| 1750725511 | Sreelata Kintala | Family Medicine | 746 The Alameda Ste 10, San Jose, CA 95126-3178 | 2013-04-24 |
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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.