Healthcare Provider Details

I. General information

NPI: 1225946635
Provider Name (Legal Business Name): JORDIN XAVIER HARPER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 SAN JOSE AVE APT 310
SAN FRANCISCO CA
94112-2476
US

IV. Provider business mailing address

2340 SAN JOSE AVE APT 310
SAN FRANCISCO CA
94112-2476
US

V. Phone/Fax

Practice location:
  • Phone: 415-553-0347
  • Fax:
Mailing address:
  • Phone: 415-553-0347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: