Jordan Waters, LICENSED PCC

NPI 1316672595 · on the registry since 2022 · sole proprietor

Practice

Address: 2000 W Briggsmore Ave
Modesto, CA 95350
Phone: (209) 526-1440
Organisation at this address: County Of Stanislaus
Center For Human Services
Center For Human Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 239

Registry record

Primary taxonomy: 101YM0800X
101YM0800X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-04-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California