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General NPI Number Information
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NPI Number | 1811370653
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Entity Type | Individual
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Provider Name | JORDAN WILLIAM HAZZARD PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 5297 COLLEGE AVE STE 107
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City | OAKLAND
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State | CA
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Zip | 94618-1797
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Country | US
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Telephone | 415-390-6725
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Fax | 415-390-6923
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Provider Business Mailing Address
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Address Line | 5297 COLLEGE AVE STE 107
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City | OAKLAND
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State | CA
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Zip | 94618-1797
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Country | US
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Telephone | 415-390-6725
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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 | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 35403
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35403
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License Number State | CA
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