Provider Demographics
NPI:1063529436
Name:THURMAN, JANIAN KAYE (MPH, RKT)
Entity type:Individual
Prefix:MS
First Name:JANIAN
Middle Name:KAYE
Last Name:THURMAN
Suffix:
Gender:F
Credentials:MPH, RKT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1974 MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3433
Mailing Address - Country:US
Mailing Address - Phone:619-804-9393
Mailing Address - Fax:
Practice Address - Street 1:5500 CAMPANILE DRIVE
Practice Address - Street 2:SAN DIEGO STATE UNIVERSITY, DEPARTMENT OF ENS
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92182-7251
Practice Address - Country:US
Practice Address - Phone:619-594-2017
Practice Address - Fax:619-594-6553
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408141-00225700000X
CA1566226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Not Answered226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist