Individual provider · Type 1 NPI

Jordan Wall

Mental Health Counselor · Azusa, CA

NPI number 1326915224 Active

Practice location

23701 E East Fork Rd
Azusa, CA 91702-1477

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1326915224

Jordan Wall's National Provider Identifier is 1326915224, issued on Oct 23, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Azusa, CA. The record was last updated on Oct 23, 2025.