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General NPI Number Information
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NPI Number | 1811418734
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Entity Type | Individual
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Provider Name | JORDAN LUCILLE JUPENA PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 4815 LIBERTY AVE STE 439
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City | PITTSBURGH
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State | PA
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Zip | 15224-2156
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Country | US
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Telephone | 412-578-3925
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Fax | 412-605-6364
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Provider Business Mailing Address
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Address Line | 400 PARNASSUS AVE FL 8
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2202
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Country | US
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Telephone | 415-353-7500
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Fax | 415-353-2889
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA059117
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA65664
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License Number State | CA
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