Trevor Davis Jordan

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

32837 Issued in CA

Practice address

800 E Ohio Ave
Escondido, CA 92025-3421

Phone

(760) 747-1275

NPI assigned

May 2, 2018

Last updated

Sep 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Keneks Therapy, Speech Therapy Corporation

  dba KENEKS Therapy

  • Speech-Language Pathologist
  • Escondido, CA
  • NPI 1497111041
  NPD
• Creative Solutions for Autism, Inc.

  dba Creative Solutions

  • Behavior Analyst
  • Costa Mesa, CA
  • NPI 1851672554
  NPD (past)

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1841789195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 WOODLAND PKWY UNIT 128",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920696412",
            "telephone_number": "707-303-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E OHIO AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253421",
            "telephone_number": "760-747-1275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3186 Airway Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926264650",
            "country_code": "US",
            "telephone_number": "714-881-0427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TREVOR",
        "middle_name": "DAVIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "32837",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley Jones, CMT
• Chelsea Hannah Jordan, COTA/L
• Diane Dela Cruz Jordan, LVN
• Joseph Deane Jordan, DDS
• Karee Ann Jordan, M.S., CCC-SLP
• Jorge Reyes Dental Corp
• Kaitlin Jorgensen
• Jose G Veliz MD Inc
• Joriel Jose
• Joseph a. Holtz D.D.S. a Professional Dental Corporation

• Speech-Language Pathologist in Escondido, CA
• Providers in Escondido, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.