Desimone, Jordan T.

Desimone, Jordan T. is an sole proprietor health care provider with primary practice located at 460 E Sacramento St , Altadena CA 91001-2915. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Desimone, Jordan T. can be contacted via phone (626) 808-0335.

Contact Information

Primary practice address
460 E Sacramento St Altadena CA 91001-2915
Phone: (626) 808-0335
Fax: (626) 270-4640
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X C039991116 California

Profile Details

NPI number 1932673563
LBN Legal business name Desimone, Jordan T.
Credentials CADC-CAS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2019
Last updated Jan 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932673563 NPPES
California Other C039991116 CALIFORNIA CONSORTIUM OF ADDICTION PROGRAMS AND PROFESSIONALS

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