Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Tara Marie Jordan, MMS, PA-C

Individual provider Physician Assistant · NPI 1366795395

Mrs. Tara Marie Jordan, MMS, PA-C is a Physician Assistant in Castro Valley, California. Licensed in California. Registered with an NPI since 2012.

Licensed in
CA
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

20055 Lake Chabot Rd Ste 130
Castro Valley, CA 94546-5331
Phone: (510) 888-0657
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA22633 (CA)

Record details

NPI number1366795395
Entity typeIndividual (Type 1)
GenderFemale
Credentials MMS , PA-C
Sole proprietorNo
NPI enumeratedOctober 15, 2012
Last updated in NPPESAugust 13, 2014

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