Jordan, Jennifer M

Jordan, Jennifer M is an sole proprietor health care provider with primary practice located at 2200 Pacific Coast Hwy Suite 209, Hermosa Beach CA 90254-2757. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jordan, Jennifer M can be contacted via phone (310) 698-2185.

Contact Information

Primary practice address
2200 Pacific Coast Hwy Suite 209 Hermosa Beach CA 90254-2757
Phone: (310) 698-2185
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY26915 California

Profile Details

NPI number 1316252513
LBN Legal business name Jordan, Jennifer M
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 11th, 2010
Last updated Jun 20th, 2018 - about 6 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 1316252513 NPPES
California Other PSY26915 LICENSE NUMBER

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