Provider Demographics
NPI:1497548382
Name:DUGAN, JORDYN MARIE (MS)
Entity type:Individual
Prefix:MS
First Name:JORDYN
Middle Name:MARIE
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 E 16TH ST APT O106
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-5909
Mailing Address - Country:US
Mailing Address - Phone:909-544-7507
Mailing Address - Fax:
Practice Address - Street 1:1940 E 16TH ST APT O106
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-5909
Practice Address - Country:US
Practice Address - Phone:909-544-7507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152309106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist