Waggoner, Grant Jordan

Waggoner, Grant Jordan is an sole proprietor health care provider with primary practice located at 24632 San Juan Ave Ste 110 , Dana Point CA 92629-3830. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Waggoner, Grant Jordan can be contacted via phone (702) 533-8324.

Contact Information

Primary practice address
24632 San Juan Ave Ste 110 Dana Point CA 92629-3830
Phone: (702) 533-8324
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 125452 California

Profile Details

NPI number 1346911450
LBN Legal business name Waggoner, Grant Jordan
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2021
Last updated Sep 28th, 2021 - about 5 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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