Individual provider Active NPI

Geoffrey Joseph Edevane, SUD COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • San Francisco, CA
National Provider Identifier
1043029671
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
RH0014141024 Issued in CA
Practice address
1111 Market St
San Francisco, CA 94103-1509
Phone
(415) 863-3883
Fax
(415) 863-7343
NPI assigned
Jan 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RH0014141024 CA Primary

Addresses

Primary practice location

1111 Market St
San Francisco, CA 94103-1509

Mailing address

1111 Market St
San Francisco, CA 94103-1509
Phone (415) 863-3883

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

State licenses

LicenseStateTypeSpecialty
RH0014141024CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1043029671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MARKET ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031509",
            "telephone_number": "415-863-3883",
            "fax_number": "415-863-7343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MARKET ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031509",
            "telephone_number": "415-863-3883",
            "fax_number": "415-863-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEVANE",
        "first_name": "GEOFFREY",
        "middle_name": "JOSEPH",
        "credential": "SUD COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RH0014141024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.