Provider Demographics
NPI:1073867396
Name:KIRSCHNER, JORDAN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JORDAN
Middle Name:
Last Name:KIRSCHNER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15235 BURBANK BLVD, SUITE B6
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411
Mailing Address - Country:US
Mailing Address - Phone:818-271-8483
Mailing Address - Fax:818-301-2394
Practice Address - Street 1:15235 BURBANK BLVD, SUITE B6
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411
Practice Address - Country:US
Practice Address - Phone:818-271-8483
Practice Address - Fax:818-301-2394
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC52266106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist