Jordan, Tara Marie

Jordan, Tara Marie is an individual health care provider with primary practice located at 20055 Lake Chabot Rd Suite 130, Castro Valley CA 94546-5331. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jordan, Tara Marie can be contacted via phone (510) 888-0657.

Contact Information

Primary practice address
20055 Lake Chabot Rd Suite 130 Castro Valley CA 94546-5331
Phone: (510) 888-0657
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA22633 California

Profile Details

NPI number 1366795395
LBN Legal business name Jordan, Tara Marie
Credentials MMS, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2012
Last updated Aug 13th, 2014 - about 11 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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