Individual
ROCHELLE LEE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 16TH ST STE B, MODESTO, CA 95354-1119
(209) 525-6150
Mailing address
920 16TH ST STE B, MODESTO, CA 95354-1119
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16795
COUNTY OF STANISLAUS
CA
Enumeration date
04/19/2019
Last updated
08/23/2023
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