Individual provider Active NPI

Jordan Alexis Gant

  • Marriage & Family Therapist
  • South Pasadena, CA
National Provider Identifier
1245647791
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
148054 Issued in CA
Practice address
205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone
(323) 344-5538
NPI assigned
Jul 16, 2014
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 148054 CA Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

205 Pasadena Ave
South Pasadena, CA 91030-2919

Mailing address

2505 Paloma St
Pasadena, CA 91104-4930

Other practice location 1

13901 Amargosa Rd
Victorville, CA 92392-2409
Phone (866) 351-8887

Other identifiers 4

IdentifierTypeStateIssuer
7667OtherCAMEDICAL
7184OtherCAMEDICAL
7708OtherCAMEDICAL
7368OtherCAMEDICAL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for the Redesign of Learning Marriage & Family Therapist Past Accepting new patients
Institute for the Redesign of Learning Marriage & Family Therapist PastSince Oct 6, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1245647791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 PALOMA ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911044930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302919",
            "telephone_number": "323-344-5538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13901 Amargosa Rd",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923922409",
            "country_code": "US",
            "telephone_number": "866-351-8887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANT",
        "first_name": "JORDAN",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "148054",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7708",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "7368",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.