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Individual
JENNIFER M JORDAN
Active
Individual
JENNIFER M JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PSY26915
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY26915
LICENSE NUMBER
CA
Enumeration date
08/11/2010
Last updated
06/20/2018
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