Individual
ASHA T JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12631 IMPERIAL HWY STE C103, SANTA FE SPRINGS, CA 90670-6735
(562) 406-7385
Mailing address
421 FLORIN RD, APT 29, SACRAMENTO, CA 95831-2075
(916) 712-2558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/19/2016
Last updated
01/18/2019
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