Provider Demographics
NPI:1356953020
Name:ROYER, JORDAN LOUISE (RN)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LOUISE
Last Name:ROYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 N HILL ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2343
Mailing Address - Country:US
Mailing Address - Phone:213-808-1720
Mailing Address - Fax:
Practice Address - Street 1:767 N HILL ST STE 400A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2381
Practice Address - Country:US
Practice Address - Phone:213-808-1720
Practice Address - Fax:213-253-0883
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95025810163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health