Asher David Jordan, M.A., ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSB94028029 Issued in CA

Practice address

9412 Big Horn Blvd
Elk Grove, CA 95758-1101

Phone

(916) 417-1116

NPI assigned

Oct 31, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1604102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1760082325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RIVER OAK CENTER FOR CHILDREN",
            "address_2": "5445 LAUREL HILLS DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958413105",
            "telephone_number": "916-827-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9412 BIG HORN BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957581101",
            "telephone_number": "916-417-1116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 Sunrise Ave # 300",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956614106",
            "country_code": "US",
            "telephone_number": "916-827-1610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9241 Old State Hwy Unit 483",
            "address_purpose": "LOCATION",
            "city": "Newcastle",
            "state": "CA",
            "postal_code": "956581420",
            "country_code": "US",
            "telephone_number": "707-736-6424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ASHER",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.A., ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-31",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "94028029",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "94028029",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94028029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.