MEDICARE: MR. DAVID JORDAN MFTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	132694	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	132694	OTHER	CA	LMFT

General Provider Information

NPI Number	:	1932516622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID JORDAN MFTI

Provider Business Mailing Address
First Line	:	7280 BLUE HILL DR STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3624
Country	:	US
Telephone Number	:	650-713-1362
Fax Number	:

Provider Business Practice Location Address
First Line	:	7280 BLUE HILL DR STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3624
Country	:	US
Telephone Number	:	650-713-1362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	10/21/2025

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Directions to “ MR. DAVID JORDAN MFTI” Practice Location

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