Jordan Holzer

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

99058366 Issued in CA

Practice address

3002 Dow Ave Ste 114
Tustin, CA 92780-7247

Phone

(714) 731-4668

NPI assigned

Nov 13, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Centra Pediatric Therapy

  • Pediatric Occupational Therapist
  • Tustin, CA
  • NPI 1902177025

  Occupational Medicine

  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1912476557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 DOW AVE STE 114",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 DOW AVE STE 114",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927807247",
            "telephone_number": "714-731-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZER",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "CA",
            "license": "99058366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Nicole Hofmeister, M.S.
• Lisa Holland-Fretz, MA, LMFT
• Shannon M. Holland, LCSW
• Norman L Hollis, DDS
• Nicole Roya Holmes
• Homedical Inc.
• Honesta Hospice and Palliative Care
• James Hong, L.AC
• Hooman M Javanmardi, Physical Therapist, a Professional Corporation
• Hooshang Dalavarian, Inc (Southern California Reference Laboratory)

• Occupational Medicine Clinic/Center in Tustin, CA
• Providers in Tustin, CA by specialty
• Occupational Medicine Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.