MEDICARE: MS. JANIAN KAYE THURMAN MPH, RKT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	408141-00	CA
2	226300000X	Kinesiotherapist	1566	CA

General Provider Information

NPI Number	:	1063529436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANIAN KAYE THURMAN MPH, RKT

Provider Business Mailing Address
First Line	:	1974 MISSOURI ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-3433
Country	:	US
Telephone Number	:	619-804-9393
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 CAMPANILE DRIVE
Second Line	:	SAN DIEGO STATE UNIVERSITY, DEPARTMENT OF ENS
City	:	SAN DIEGO
State	:	CA
Zip	:	92182-7251
Country	:	US
Telephone Number	:	619-594-2017
Fax Number	:	619-594-6553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	09/11/2025

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