IMANI JORDAN (NPI# 1407405624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407405624 |
| Entity Type | Individual |
| Full Name | IMANI JORDAN |
| Practice Address |
1910 Olympic Blvd Ste 140&150 Walnut Creek CA 94596-5096 |
| Mailing Address |
21600 Oxnard St Woodland Hills CA 91367-4976 |
| Practice Telephone | 9254330990 |
| Mailing Telephone | 8183452345 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | E2998425 | CA | Behavioral Health & Social Service Providers |
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 103K00000X | Behavioral Analyst | CA | Behavioral Health & Social Service Providers |
| Street Address |
1910 OLYMPIC BLVD STE 140&150 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932421138 | Loryn A Avalos | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596 | 2010-02-16 |
| 1912531914 | Kelsey F Skinner | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2020-02-27 |
| 1972148237 | Joey Shin | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2019-11-11 |
| 1053952895 | Kyriele Webb | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2019-10-02 |
| 1225687213 | Cariann Lynn Perumal | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2019-09-11 |
| 1497213979 | Joslyn Almes Navera | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2019-03-04 |
| 1912479312 | Michael Clifford Borba | Behavioral Analyst | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2018-12-23 |
| 1386129286 | Marie Ange Christine Brou | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2018-09-27 |
| 1417442831 | Marcus Sean Mcrae | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2018-06-27 |
| 1336634260 | John Daniel Kelly | Behavior Technician | 1910 Olympic Blvd Ste 140&150, Walnut Creek, CA 94596-5096 | 2018-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384202 | Be Still Be Connected LLC | Behavioral Analyst | 1469 Creekside Dr Apt 2018, Walnut Creek, CA 94596-5697 | 2019-12-26 |
| 1518509124 | Alexandra L Mogilevets | Behavioral Analyst | 2423 Exbourne Ct, Walnut Creek, CA 94596-6406 | 2019-10-15 |
| 1811460512 | Eunice Shin | Behavioral Analyst | 1990 N California Blvd Fl 8, Walnut Creek, CA 94596-3742 | 2019-01-04 |
| 1871068221 | Rosario Jo A Villanueva | Behavioral Analyst | 1265 Montego Apt 39, Walnut Creek, CA 94598-2844 | 2018-10-11 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1043794316 | Christopher Labreche | Behavioral Analyst | 2730 Shadelands Dr Ste 100, Walnut Creek, CA 94598-2540 | 2018-09-21 |
| 1487134599 | Christi Stencil | Behavioral Analyst | 39 Quail Ct Ste 203, Walnut Creek, CA 94596-5569 | 2018-08-17 |
| 1356827943 | Amber Brown-woods | Behavioral Analyst | 1966 Tice Valley Blvd # 112, Walnut Creek, CA 94595-2203 | 2018-07-17 |
| 1285141465 | Brianna Elise Fitchett | Behavioral Analyst | 2820 Shadelands Dr Ste 200, Walnut Creek, CA 94598-2525 | 2018-01-09 |
| 1548704513 | Thea Nicole Harris | Behavioral Analyst | 1457 Via Loma, Walnut Creek, CA 94598-2926 | 2016-12-11 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.