Provider Demographics
NPI:1740842079
Name:JOURDAN, RACHEL (BCBA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:JOURDAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3110
Mailing Address - Country:US
Mailing Address - Phone:415-290-6299
Mailing Address - Fax:
Practice Address - Street 1:1440 N ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-2814
Practice Address - Country:US
Practice Address - Phone:202-588-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1-15-21135103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst