Provider Demographics
NPI:1053951483
Name:RYMEL, JORDANAH ELAINE
Entity type:Individual
Prefix:
First Name:JORDANAH
Middle Name:ELAINE
Last Name:RYMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2928 HAMMONTON SMARTVILLE RD SPC 57
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-8028
Mailing Address - Country:US
Mailing Address - Phone:530-812-4548
Mailing Address - Fax:
Practice Address - Street 1:448 GARDEN HWY
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6348
Practice Address - Country:US
Practice Address - Phone:530-702-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7836599103K00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst