Individual
JORDAN MICHAEL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 EUREKA RD STE 102, ROSEVILLE, CA 95661-2849
(916) 759-1168
Mailing address
18225 HALE AVE STE 200, MORGAN HILL, CA 95037-3547
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
04/23/2025
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