Provider Demographics
NPI:1871391979
Name:JORDAN, JOAQUIN FEW (SUDCC III, SAP)
Entity type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:FEW
Last Name:JORDAN
Suffix:
Gender:
Credentials:SUDCC III, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 JORDANS PL
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8742
Mailing Address - Country:US
Mailing Address - Phone:530-520-3971
Mailing Address - Fax:
Practice Address - Street 1:22 JORDANS PL
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8742
Practice Address - Country:US
Practice Address - Phone:530-520-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA173944101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)