Active NPI
Rochelle Lee Jordan
- Peer Specialist
- Modesto, CA
National Provider Identifier
1861055394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 920 16TH St Ste B
Modesto, CA 95354-1119 - Phone
- (209) 525-6150
- NPI assigned
- Apr 19, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
920 16TH St Ste B
Modesto, CA 95354-1119
Mailing address
920 16TH St Ste B
Modesto, CA 95354-1119
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16795 | Other | CA | COUNTY OF STANISLAUS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1861055394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 16TH ST STE B",
"city": "MODESTO",
"state": "CA",
"postal_code": "953541119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 16TH ST STE B",
"city": "MODESTO",
"state": "CA",
"postal_code": "953541119",
"telephone_number": "209-525-6150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ROCHELLE",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-19",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNTY OF STANISLAUS",
"identifier": "16795",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.