Provider Demographics
NPI:1801369863
Name:BUNTING, JORDAN ELIZABETH (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:ELIZABETH
Last Name:BUNTING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 SANTA MONICA BLVD # 63
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2478
Mailing Address - Country:US
Mailing Address - Phone:949-482-5937
Mailing Address - Fax:
Practice Address - Street 1:5101 SANTA MONICA BLVD # 63
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2478
Practice Address - Country:US
Practice Address - Phone:949-482-5937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110825106H00000X
CA120569106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist