Active NPI
Pamela Jordan, CAS REGISTERED 12139
- Addiction (Substance Use Disorder) Counselor
- Lompoc, CA
National Provider Identifier
1336407048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 12139
- Practice address
- 110 S. 'C' St. Ste. a
Family Service Agency
Lompoc, CA 93436 - Phone
- (805) 735-4376
- Fax
- (805) 737-3251
- NPI assigned
- May 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 12139 | CA | Primary |
Addresses
Primary practice location
110 S. 'C' St. Ste. a
Family Service Agency
Lompoc, CA 93436
Mailing address
123 West Gutierrez St.
Family Service Agency Santa Barbara
Santa Barbara, CA 93101
Phone (805) 965-1001
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12139 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Barbara County Auditor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Lompoc, CA
- NPI 1649096249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1336407048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 WEST GUTIERREZ ST.",
"address_2": "FAMILY SERVICE AGENCY SANTA BARBARA",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "93101",
"telephone_number": "805-965-1001",
"fax_number": "805-965-2178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S. 'C' ST. STE. A",
"address_2": "FAMILY SERVICE AGENCY",
"city": "LOMPOC",
"state": "CA",
"postal_code": "93436",
"telephone_number": "805-735-4376",
"fax_number": "805-737-3251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "PAMELA",
"credential": "CAS REGISTERED 12139",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-01",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "12139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.