Provider Demographics
NPI:1730854746
Name:VALDEZ, JORDAN MARIA (ND, RD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:MARIA
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:ND, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2544 NAVARRA DR UNIT 17
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7057
Mailing Address - Country:US
Mailing Address - Phone:469-877-7948
Mailing Address - Fax:
Practice Address - Street 1:2544 NAVARRA DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-7054
Practice Address - Country:US
Practice Address - Phone:469-877-7948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
CA1370175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered