Individual
ANTONIA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6265 SEPULVEDA BLVD, VAN NUYS, CA 91411-1114
(818) 779-0555
Mailing address
26460 SUMMIT CIR, SANTA CLARITA, CA 91350-2991
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/10/2008
Last updated
01/10/2008
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