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Jordan Isiah Anthony Wilborn
Licensed Psychiatric Technician in Lynwood, California
NPI 1942974050

Jordan Isiah Anthony Wilborn is a Licensed Psychiatric Technician based in Lynwood, CA. Jordan Isiah Anthony Wilborn practices in Lynwood, CA. The NPI Number for Jordan Isiah Anthony Wilborn is 1942974050 and holds a License No. (California).

The current practice location address for Jordan Isiah Anthony Wilborn is 2640 Industry Way, Lynwood, CA and can be reached out via phone at 310-627-4525 and via fax at 310-945-3356.

Location: 2640 Industry Way, Lynwood, CA, 90262-4284
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942974050
Provider Name
Jordan Isiah Anthony Wilborn
Credential
Provider Entity Type
Individual
Gender
Male
Address
2640 Industry Way, Lynwood, CA, 90262-4284
Phone Number
310-627-4525
Fax Number
310-945-3356
Provider Enumeration Date
08/03/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2640 Industry Way
City
Lynwood
State
California
Zip
90262-4284
Phone Number
310-627-4525
Fax Number
310-945-3356
person
Provider Business Mailing Address Details
Address
2640 Industry Way
City
Lynwood
State
California
Zip
90262-4284
Phone Number
310-627-4525
Fax Number
310-945-3356
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Psychiatric Technician
Speciality
-
Taxonomy
167G00000X
License No.
42594 (California)
Definition
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
person
Provider's Taxonomy Details 2
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
225400000X
License No.
()
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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