Individual provider Active NPI

Jordan Allan, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1083016612
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110515 Issued in CA
Practice address
5630 Venice Blvd #1107
Virtual
Los Angeles, CA 90019
Phone
(818) 273-6203
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 33012256A IN
Clinical Social Worker 1041C0700X 110515 CA Primary

Addresses

Primary practice location

5630 Venice Blvd #1107
Virtual
Los Angeles, CA 90019

Mailing address

5630 Venice Blvd # 1107
Los Angeles, CA 90019-5127
Phone (818) 273-6203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110515CAMDClinical Social Worker
33012256AINMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1083016612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 VENICE BLVD # 1107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900195127",
            "telephone_number": "818-273-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 VENICE BLVD #1107",
            "address_2": "VIRTUAL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90019",
            "telephone_number": "818-273-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLAN",
        "first_name": "JORDAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "33012256A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "110515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.