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Individual

GEORGE JORDAN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4892 SAN PABLO DAM RD, EL SOBRANTE, CA 94803-3222
(510) 223-4236
Mailing address
60 GOLD CREST CT, PITTSBURG, CA 94565-6500

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
B5209333
CA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
NPPES
CA
373H00000X
Day Training/Habilitation Specialist
Primary
B5209333
CA

Other

Enumeration date
11/17/2022
Last updated
02/17/2026
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