Jordan Douglas Sanders, AG-ACNP
Nurse Practitioner in Santa Maria, CA. Individual provider (NPI-1).
NPI number1619709805
StatusActive
Last updated in NPPESJun 30, 2025
Details
- NPI
- 1619709805
- Entity type
- Individual (NPI-1)
- Name
- Jordan Douglas Sanders
- Credential
- AG-ACNP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 15, 2024
- Certification date
- Jun 30, 2025
- Last updated
- Jun 30, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 95034111 | CA | Yes |
| 163WC0200X | Registered Nurse, Critical Care Medicine | 95211424 | CA |
Practice location
1510 E Main St Ste 104cSanta Maria, CA 93454-4825
Phone 805-928-5767 · Fax 805-349-0222
Mailing address
3231 Orcutt Rd Apt 3Santa Maria, CA 93455-2396
Phone 325-668-7031
Other practice locations
1900 Pine St
Abilene, TX 79601-2432
Abilene, TX 79601-2432
Phone 412-371-9133
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