Jordan Elizalde
Behavior Technician in Concord, CA. Individual provider (NPI-1).
NPI number1548034895
StatusActive
Last updated in NPPESNov 8, 2023
Details
- NPI
- 1548034895
- Entity type
- Individual (NPI-1)
- Name
- Jordan Elizalde
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 8, 2023
- Certification date
- Nov 7, 2023
- Last updated
- Nov 8, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1200 Concord Ave Ste 100Concord, CA 94520-4969
Phone 510-268-8120
Mailing address
5144 1/2 Riverton AveNorth Hollywood, CA 91601-4782
Phone 415-769-9294
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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