NPI 1154898062 · live from the CMS NPI Registry
Jordan A Bleecker, PA-C
Physician Assistant in Ventura, CA. National Provider Identifier 1154898062, active.
NPI record
| NPI | 1154898062 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 147 N Brent St, Ventura, CA 93003 |
| Practice phone | 805-948-8277 |
| Enumerated | October 29, 2018 |
| Last updated | August 13, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Physician Assistant primary | 363A00000X | 59589 (CA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.