Healthcare Provider Details

I. General information

NPI: 1861200941
Provider Name (Legal Business Name): JORDAN CHRISTINE HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6121 E CORTLAND AVE
FRESNO CA
93727-8931
US

IV. Provider business mailing address

7080 N WHITNEY AVE
FRESNO CA
93720-0154
US

V. Phone/Fax

Practice location:
  • Phone: 415-548-1625
  • Fax:
Mailing address:
  • Phone: 559-325-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number140001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: