Provider Demographics
NPI:1730188608
Name:JORDAN, MARION JOANNA (PA)
Entity type:Individual
Prefix:MS
First Name:MARION
Middle Name:JOANNA
Last Name:JORDAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1080 EMELINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1966
Mailing Address - Country:US
Mailing Address - Phone:831-454-5401
Mailing Address - Fax:831-454-4488
Practice Address - Street 1:1080 EMELINE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1966
Practice Address - Country:US
Practice Address - Phone:831-454-7526
Practice Address - Fax:831-454-4296
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2025-02-19
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Provider Licenses
StateLicense IDTaxonomies
CA13409363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant