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Individual
MS. JORDAN DUNYASHA VIX
Active
Individual
MS. JORDAN DUNYASHA VIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW/LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
20718
CA
1041C0700X
Clinical Social Worker
Primary
25864
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159510
IS SVX LOC #
CA
01
—
HI557Z
PTAN
CA
01
—
W2983
MEDICARE GROUP
CA
Enumeration date
03/02/2007
Last updated
10/24/2013
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