Healthcare Provider Details

I. General information

NPI: 1831824218
Provider Name (Legal Business Name): JORDAN ALEXANDRIA LAMPI LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2022
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 BAYSIDE RD STE B
ARCATA CA
95521-7102
US

IV. Provider business mailing address

381 BAYSIDE RD STE B
ARCATA CA
95521-7102
US

V. Phone/Fax

Practice location:
  • Phone: 707-625-5794
  • Fax: 707-462-8831
Mailing address:
  • Phone: 707-625-5794
  • Fax: 707-462-8831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number155906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: