JORDAN PAUL (NPI# 1710540034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710540034 |
| Entity Type | Individual |
| Full Name | JORDAN PAUL |
| Credential | RADT |
| Practice Address |
623 N Main St Corona CA 92880-1407 |
| Practice Telephone | 9094889477 |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
R1333970119 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730595521 | Jordan Max Paul | Optometrist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2014-07-01 |
| Street Address |
623 N MAIN ST |
| City | CORONA |
| State | CA |
| Zip Code | 92880-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982071155 | Raul Lopez | Counselor | 623 N Main St, Corona, CA 92880-1407 | 2015-08-24 |
| 1679807671 | Annie M Leicht | Counselor | 623 N Main St, Suite D-11, Corona, CA 92880-1407 | 2009-09-23 |
| 1841335130 | Lucille Andrea Yglesias | Counselor | 623 N Main St, Suite D-11, Corona, CA 92880-1407 | 2007-02-21 |
| 1174661474 | Stephanie A Marsh | Counselor | 623 N Main St, Suite D11, Corona, CA 92880-1407 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568084945 | Eastvale Family Care Inc. | Family Medicine | 14252 Schleisman Rd., Eastvale, CA 92880 | 2020-05-08 |
| 1982226460 | Eastvale Urgent Care Inc | Clinic/Center | 14252 Schleisman Rd, Eastvale, CA 92880 | 2020-05-07 |
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1184274029 | Rocquel Mack | Licensed Vocational Nurse | 2131 Shelley Circle, Corona, CA 92880 | 2019-09-12 |
| 1255993176 | Symbiosis, Inc. | Clinic/Center | 3115 Palisades Drive, Corona, CA 92880 | 2019-07-01 |
| 1770065559 | Kumkum Mehta | Nurse Practitioner | 7391 Sungold Ave, Corona, CA 92880 | 2018-08-29 |
| 1629559802 | Skt Therapy Inc | Marriage & Family Therapist | 765 N Main St Ste 152, Corona, CA 92880 | 2018-08-24 |
| 1356854145 | Hk Durgs Inc | Pharmacy | 13394 Limonite Ave, Ste 120, Eastvale, CA 92880 | 2017-11-15 |
| 1134638653 | National Vision, Inc. | Technician/Technologist | 482 Main Street, Corona, CA 92880 | 2017-09-27 |
| 1922527464 | Crown Care Transportation | Non-emergency Medical Transport (VAN) | 13557 Nectarine Ave, Corona, CA 92880 | 2017-09-15 |
| Find all providers in zip 92880 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952928509 | Eric Lee Silva | Counselor | 1623 S Lincoln Ave, Corona, CA 92882-3911 | 2020-06-30 |
| 1851921134 | Victor Candela Jr. | Counselor | 1655 E 6th St Ste B6, Corona, CA 92879-1719 | 2020-01-25 |
| 1063952307 | Wendy Catalina Villafana | Counselor | 9609 40th Rd, Corona, NY 11368-2138 | 2017-03-06 |
| 1720436546 | Tammy Fogle | Counselor | 245 N Lincoln Ave, Corona, CA 92882-1851 | 2016-06-02 |
| 1073956330 | Gloria Quaid | Counselor | 2178 Devonshire Dr, Corona, CA 92879-3162 | 2013-04-16 |
| 1285997783 | Shresia Deon Fontenot-kenney | Counselor | 1064 Riverbend Cir, Corona, CA 92881-8685 | 2012-06-19 |
| 1891984126 | Lloyd Alan Wager | Counselor | 370 West Grand Blvd Ste 104, Corona, CA 92882 | 2007-10-23 |
| 1972797819 | April Kimberly Moore | Counselor | 710 Rimpau Ave Ste 102, Corona, CA 92879-5724 | 2007-09-04 |
| 1386834745 | Deneen Leo Watson | Counselor | 615 Robin Ct, Corona, CA 92879-3138 | 2007-07-31 |
| 1740335330 | Evelyn Sosa | Counselor | 109 E 11th St, Corona, CA 92879-2157 | 2007-01-24 |
| Find all providers in CORONA | ||||
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| 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.