Javellana, Jordan Tyler G

Javellana, Jordan Tyler G is an individual health care provider with primary practice located at 139 Lisa Ln Apt C , Costa Mesa CA 92627-9468. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Javellana, Jordan Tyler G can be contacted via phone (714) 686-1431.

Contact Information

Primary practice address
139 Lisa Ln Apt C Costa Mesa CA 92627-9468
Phone: (714) 686-1431
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA63252 California

Profile Details

NPI number 1679359665
LBN Legal business name Javellana, Jordan Tyler G
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2023
Last updated Sep 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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