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MR. KYLE ANDREW JORDAN CADC II, ICADC, AS
NPI 1124686910
Counselor - Addiction (Substance Use Disorder) in Campo, CA

Active since June 05, 2019
1777 BUCKMAN SPRINGS RD, CAMPO, CA 91906(619) 478-5696(619) 478-2404 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 27, 2025, Nov 8, 2023, Jan 25, 2023 and 1 more (4 updates tracked since 2019).

About Mr. Kyle Andrew Jordan Cadc Ii, Icadc, As NPPES

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

MR. KYLE ANDREW JORDAN CADC II, ICADC, AS (NPI 1124686910) is an individual addiction (substance use disorder) provider in Campo, California, licensed in California (A063351023) and active in the NPI registry since June 2019.

NPPES Registry Identity

NPI1124686910
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. KYLE ANDREW JORDANCredential: CADC II, ICADC, AS
Location Address1777 BUCKMAN SPRINGS RDCampo, CA 91906-2022
Mailing Address1777 Buckman Springs RdCampo, CA 91906-2022 · (619) 478-5696 · Fax (619) 478-2404
Phone(619) 478-5696
Fax(619) 478-2404
Sole ProprietorNo
Enumeration DateJune 5, 2019
Last NPPES UpdateMarch 27, 20254 updates tracked since enumeration
NPPES CertifiedMarch 27, 2025
✔ NPI 1124686910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · A063351023
1777 BUCKMAN SPRINGS RD, Campo, CA 91906
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Other Providers at the Same Location NPPES 20

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

OMAR HERNANDEZ RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
JONATHAN SANDOVAL CCMA
Physician Assistant
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
MR. MARCO MARTINEZ RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CORINNA D. BYNUM RN
Registered Nurse (Administrator)
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
TIM SHAPLIN RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
SAN DIEGO FREEDOM RANCH, INC.
Substance Abuse Rehabilitation Facility
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CARLOS ALBERTO RAMIREZ RADT
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696
CHRISTOPHER DAVID SERNA CPSS
Counselor (Addiction (Substance Use Disorder))
1777 BUCKMAN SPRINGS RD
CAMPO, CA 91906
San Diego County (619) 478-5696

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Jordan's NPI number?

The NPI number for Kyle Jordan is 1124686910. It was assigned to this individual provider in the NPPES registry on June 5, 2019.

Where is Kyle Jordan located?

Kyle Jordan practices at 1777 Buckman Springs Rd, Campo, CA 91906. The listed phone number is (619) 478-5696.

What is Kyle Jordan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kyle Jordan was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.