Provider Demographics
NPI:1235655853
Name:EPSTEIN, JORDANA
Entity Type:Individual
Prefix:
First Name:JORDANA
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15023 DICKENS ST APT 11
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3476
Mailing Address - Country:US
Mailing Address - Phone:818-667-5485
Mailing Address - Fax:
Practice Address - Street 1:15233 VENTURA BLVD STE 1216
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2274
Practice Address - Country:US
Practice Address - Phone:323-510-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist