Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 28433 | CA |
Y | 103G00000X | Clinical Psychologist | 28433 | CA |
Y | 103TC0700X | Clinical Psychologist | 28433 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 28433 | CA |
NPI | 1124351267 |
---|---|
Provider Name | Dr. Jordyn S Trockman |
First Address | Playa Vista, CA 90094-3039 |
Second Address | Playa Vista, CA 90094-3039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2009 |
Last Update Date | 26/11/2019 |