MEDICARE: JORDAN UNFRIED PPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor	200156335	CA

General Provider Information

NPI Number	:	1518835511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN UNFRIED PPS

Provider Business Mailing Address
First Line	:	700 PACIFIC ST
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-2864
Country	:	US
Telephone Number	:	831-645-1261
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 NOCHE BUENA ST
Second Line	:
City	:	SEASIDE
State	:	CA
Zip	:	93955-3145
Country	:	US
Telephone Number	:	831-645-1261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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Directions to “ JORDAN UNFRIED PPS” Practice Location

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