Jordan Sullivan

NPI 1083199434 · on the registry since 2018 · sole proprietor

Practice

Address: 1520 Eureka Rd Ste 102
Roseville, CA 95661
Phone: (916) 759-1168
Organisation at this address: Victor Community Support Services
Victor Community Support Services, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 23

Registry record

Primary taxonomy: 373H00000X
373H00000X
Also registered as: 101Y00000X
101YM0800X
106S00000X
171M00000X
172V00000X
225400000X
Sex: Male
Record last updated: 2025-04-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California