Individual provider · Type 1 NPI

Jordan Samuel

Student in an Organized Health Care Education/Training Program · Colton, CA

NPI number 1366325649 Active

Practice location

2291 Lalique Cir
Colton, CA 92324-9242

Call (901) 734-3464 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1366325649

Jordan Samuel's National Provider Identifier is 1366325649, issued on Jul 26, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Colton, CA. The record was last updated on Jul 26, 2025.