Jordan Michael Sullivan, is a
Day Training/habilitation Specialist based in Roseville, California. Jordan Michael Sullivan is licensed to practice in NU (license number ) and his current practice location is
1520 Eureka Rd Ste 102, Roseville, California. He can be reached at his office (for appointments etc.) via phone at
(916) 759-1168.
NPI number for Jordan Michael Sullivan is 1083199434 and his current mailing address is 18225 Hale Ave Ste 200, Morgan Hill, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1083199434.
Healthcare Provider's Profile
| Full Name | Jordan Michael Sullivan |
|---|
| Gender | Male |
|---|
| Speciality | Day Training/habilitation Specialist |
|---|
| Location | 1520 Eureka Rd Ste 102, Roseville, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1083199434
- Provider Enumeration Date: 10/02/2018
- Last Update Date: 04/23/2025
Medical Identifiers
Medical identifiers for Jordan Michael Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083199434 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (NU) | Secondary |
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 373H00000X | Day Training/habilitation Specialist | (NU) | Primary |
| 225400000X | Rehabilitation Practitioner | (NU) | Secondary |
| 172V00000X | Community Health Worker | (NU) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (NU) | Secondary |
| 106S00000X | Behavior Technician | (NU) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jordan Michael Sullivan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jordan Michael Sullivan,
18225 Hale Ave Ste 200,
Morgan Hill, CA 95037-3547
Ph: Not Available | Jordan Michael Sullivan,
1520 Eureka Rd Ste 102,
Roseville, CA 95661-2849
Ph: (916) 759-1168 |
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