Individual provider Active NPI

Jamie Edwards, MS, LEP

  • School Psychologist
  • Martinez, CA
National Provider Identifier
1013637776
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
3419 Issued in CA
Practice address
360 Lindsey Dr
Martinez, CA 94553-5738
Phone
(925) 413-7968
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3419 CA Primary

Addresses

Primary practice location

360 Lindsey Dr
Martinez, CA 94553-5738

Mailing address

360 Lindsey Dr
Martinez, CA 94553-5738
Phone (925) 413-7968

Other practice location 1

1407 Oakland Blvd Ste 108
Walnut Creek, CA 94596-4300
Phone (925) 954-9229

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL port Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3419CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Child Assessment & Counseling, Inc School PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1013637776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 LINDSEY DR",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945535738",
            "telephone_number": "925-413-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 LINDSEY DR",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945535738",
            "telephone_number": "925-413-7968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1407 Oakland Blvd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945964300",
            "country_code": "US",
            "telephone_number": "925-954-9229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JAMIE",
        "name_prefix": "Mrs.",
        "credential": "MS, LEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "3419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "port",
            "affiliation": "N",
            "endpointDescription": "port",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "360 Lindsey Dr",
            "city": "Martinez",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945535738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.