Healthcare Provider Details

I. General information

NPI: 1730094475
Provider Name (Legal Business Name): JENMUEL QUINN F LANUZA PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3158 LANDESS AVE APT D
SAN JOSE CA
95132-1266
US

IV. Provider business mailing address

3158 LANDESS AVE APT D
SAN JOSE CA
95132-1266
US

V. Phone/Fax

Practice location:
  • Phone: 408-230-3750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: