Active NPI
Jordan Elyse Dunham, M.A., BCBA
- Behavior Analyst
- Costa Mesa, CA
National Provider Identifier
1740733757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-16-22804
- Practice address
- 3152 Red Hill Ave Ste 100
Costa Mesa, CA 92626-3418 - Phone
- (714) 881-0427
- NPI assigned
- Jul 26, 2016
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-16-22804 | CA | Primary |
Addresses
Primary practice location
3152 Red Hill Ave Ste 100
Costa Mesa, CA 92626-3418
Mailing address
18 Le Mans
Mission Viejo, CA 92692-5162
Phone (925) 998-6985
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1740733757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 LE MANS",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926925162",
"telephone_number": "925-998-6985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3152 RED HILL AVE STE 100",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926263418",
"telephone_number": "714-881-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "JORDAN",
"middle_name": "ELYSE",
"name_prefix": "Mrs.",
"credential": "M.A., BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-26",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-16-22804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.