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General NPI Number Information
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NPI Number | 1205485018
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Entity Type | Individual
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Provider Name | JORDYN SKAGGS
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1010 TURQUOISE ST
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City | SAN DIEGO
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State | CA
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Zip | 92109-1259
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Country | US
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Telephone | 206-747-4315
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 TURQUOISE ST
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City | SAN DIEGO
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State | CA
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Zip | 92109-1259
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY.0006857
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License Number State | CO
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