JORDAN MICHAEL SULLIVAN
NPI 1083199434
Day Training/Habilitation Specialist in Roseville, CA

Q: What is Jordan Sullivan's NPI number?

The NPI number for Jordan Sullivan is 1083199434. It was assigned to this individual provider in the NPPES registry on October 2, 2018.

Q: What is Jordan Sullivan's specialty?

The primary specialty registered for this NPI is Day Training/Habilitation Specialist with taxonomy code 373H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Sullivan was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 02, 2018

1520 EUREKA RD STE 102, ROSEVILLE, CA 95661(916) 759-1168 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 11, 2025, Jun 16, 2023, Jan 21, 2022 and 2 more (5 updates tracked since 2018).

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About Jordan Michael Sullivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN MICHAEL SULLIVAN (NPI 1083199434) is an individual day training/habilitation specialist in Roseville, California and active in the NPI registry since October 2018.

NPPES Registry Identity

NPI1083199434

Entity TypeIndividualMale

Primary Taxonomy373H00000X

Provider Legal NameJORDAN MICHAEL SULLIVAN

Location Address1520 EUREKA RD STE 102Roseville, CA 95661-2849

Mailing Address18225 Hale Ave Ste 200Morgan Hill, CA 95037-3547

Phone(916) 759-1168

Sole ProprietorYes

Enumeration DateOctober 2, 2018

Last NPPES UpdateApril 23, 20255 updates tracked since enumeration

NPPES CertifiedApril 23, 2025

✔ NPI 1083199434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyDay Training/Habilitation SpecialistNursing Service Related Providers

Taxonomy Code373H00000X

Definition

Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living.

Also ListedCounselorTaxonomy 101Y00000X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedBehavior TechnicianTaxonomy 106S00000X

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedCommunity Health WorkerTaxonomy 172V00000X

Also ListedRehabilitation PractitionerTaxonomy 225400000X

1520 EUREKA RD STE 102, Roseville, CA 95661

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Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICTOR COMMUNITY SUPPORT SERVICES

Clinic/Center (Mental Health (Including Community Mental Health Center))