| Doctor Name: | CAROL JEAN JORDAN |
| NPI Number: | 1023021599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MFT |
| License Number: | MFC 36474 |
| Business Practice Address: | 5747 Watt Ave North Highlands, CA - 956604751 |
| Business Phone Number: | 9168768023 |
| Business Fax Number: | 9168767470 |
| Mailing Address: | 10001 Woodcreek Oaks Blvd Apt 517, ROSEVILLE |
| State: | CA |
| Postal Code: | 957475103 |
| Phone Number: | 9167732886 |
| Fax Number: | |
| NPI Enumeration Date: | 08/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MFC 36474 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |