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General NPI Number Information
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NPI Number | 1497831770
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Entity Type | Individual
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Provider Name | KATHLEEN ANN JORDAN FNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2006
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 585 N MARY AVE
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City | SUNNYVALE
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State | CA
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Zip | 94085-2905
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Country | US
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Telephone | 888-755-7855
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Fax |
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Provider Business Mailing Address
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Address Line | 391 CHURCH ST
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-2120
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Country | US
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Telephone | 650-961-2614
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN373149 NP 11039
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License Number State | CA
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