Healthcare Provider Details

I. General information

NPI: 1497605281
Provider Name (Legal Business Name): JORDAN MUNRO-RANKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 6TH ST
CORONADO CA
92118-1600
US

IV. Provider business mailing address

4026 TRAIL BLAZE CT
BONITA CA
91902-3043
US

V. Phone/Fax

Practice location:
  • Phone: 850-206-7708
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: