Individual provider · Type 1 NPI
Deadra Jordan, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · San Francisco, CA
NPI number
1366052805
Active
Practice location
5214F Diamond Heights Blvd # 3422
San Francisco, CA 94131-2175
Fax (903) 212-7839
Mailing address
13102 FM 839 S
Henderson, TX 75654-6278
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95017044 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 1014434 (TX) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1366052805
Deadra Jordan, PMHNP-BC's National Provider Identifier is 1366052805, issued on Aug 7, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Francisco, CA. The record was last updated on Aug 5, 2025.