Individual
JORDAN LUCILLE JUPENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 PARNASSUS AVE FL 2, SAN FRANCISCO, CA 94143-2202
(415) 353-8595
(415) 353-2919
Mailing address
400 PARNASSUS AVE FL 2, SUITE A2300, SAN FRANCISCO, CA 94143-2202
(415) 353-8595
(415) 353-2919
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA059117
PA
363AM0700X
Medical Physician Assistant
Primary
PA65664
CA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103325844
—
PA
01
—
14055112
CAQH
—
Enumeration date
06/30/2017
Last updated
04/17/2026
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