DR. JORDAN PAUL BACKSTROM (NPI# 1124552708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124552708 |
| Entity Type | Individual |
| Full Name | DR. JORDAN PAUL BACKSTROM |
| Credential | PSY.D |
| Practice Address |
85 1st Ave Waltham MA 02451-1105 |
| Practice Telephone | 7818957963 |
| Mailing Telephone | 7818957963 |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
10520 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376958009 | Jordan Backstrom | Physical Therapist | 215 Highway 2 Sw Stuite 103, Rugby, ND 58368 | 2014-06-20 |
| Street Address |
85 1ST AVE |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962465070 | James Christopher O'brien | Internal Medicine | 85 1st Ave, Waltham, MA 02451-1105 | 2006-04-10 |
| 1598288987 | Hannah Potler | Registered Nurse | 85 1st Ave, Waltham, MA 02451-1105 | 2017-07-18 |
| 1255867487 | Boston Paincare Center | Clinical Medical Laboratory | 85 1st Ave, Waltham, MA 02451-1105 | 2017-05-09 |
| 1255709556 | Valerie Florence Weed | Psychologist | 85 1st Ave, Waltham, MA 02451-1105 | 2015-09-03 |
| 1114338308 | Marina Treglia | Registered Nurse | 85 1st Ave, Waltham, MA 02451-1105 | 2014-05-11 |
| 1558791475 | Boston Paincare Center | Pain Medicine | 85 1st Ave, Waltham, MA 02451-1105 | 2013-11-13 |
| 1780020990 | Kelly Michelle Wawrzyniak | Psychologist | 85 1st Ave, Waltham, MA 02451-1105 | 2013-05-14 |
| 1578806170 | Nicholas Reese Barnes | Psychiatry & Neurology | 85 1st Ave, Waltham, MA 02451-1105 | 2013-04-02 |
| 1821341264 | Katherine Nycz | Registered Nurse | 85 1st Ave, Waltham, MA 02451-1105 | 2012-10-23 |
| 1750643706 | Sarah Stollar Smith | Nurse Practitioner | 85 1st Ave, Waltham, MA 02451-1105 | 2012-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558850479 | Laurie Horowitz Humbert | Psychologist | 60 Clements Rd, Waltham, MA 02453-8208 | 2018-05-07 |
| 1467978569 | Rachel Margaret Kantor | Psychologist | 860 Winter St, Waltham, MA 02451-1449 | 2017-08-21 |
| 1750779005 | Katherine L E Craigen | Psychologist | 69 Hickory Dr Ste 2000, Waltham, MA 02451-1011 | 2015-01-08 |
| 1972903250 | Emily Brooke Hotz | Psychologist | 40 Crescent St Ste 201, Waltham, MA 02453-4313 | 2014-08-24 |
| 1770992059 | Hope Elisabeth Forbes | Psychologist | 175 Forest St., Bentley University Counseling Center, Waltham, MA 02452 | 2014-08-12 |
| 1992015275 | Julia Fomicheva | Psychologist | 411 Waverley Oaks Rd., #104, Waltham, MA 02452-8449 | 2010-10-20 |
| 1477792679 | Ronald Howard Evans | Psychologist | 415 South St., Brandeis University, Psychological Counseling, Mailman, Waltham, MA 02454-9110 | 2009-02-11 |
| 1871768762 | Vicky Lyn Anderson | Psychologist | 45 South Street Mailmun House, Brandeis University Psychological Counseling Center, Waltham, MA 02453 | 2008-04-23 |
| 1902023591 | Jane L. Forsyth | Psychologist | 30 Curve Street, Waltham, MA 02451 | 2007-04-18 |
| 1982752168 | Aurelie Jones Goodwin | Psychologist | 159 Virginia Rd, Waltham, MA 02453-7615 | 2007-01-06 |
| Find all providers in WALTHAM | ||||
Please comment or provide details below to improve the information on DR. JORDAN PAUL BACKSTROM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.