Provider Demographics
NPI:1710216254
Name:JORDAN, JANE C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:C
Last Name:JORDAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 STEINER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3908
Mailing Address - Country:US
Mailing Address - Phone:415-931-5730
Mailing Address - Fax:415-931-5802
Practice Address - Street 1:3022 STEINER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3908
Practice Address - Country:US
Practice Address - Phone:415-931-5730
Practice Address - Fax:415-931-5802
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS5115102L00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical