Active NPI
Laurie Edwards
- Psychoanalyst
- Oakland, CA
National Provider Identifier
1083037089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalyst
- License
- LCSW5402
- Practice address
- 21 Castle LN
Oakland, CA 94611-2743 - Phone
- (510) 482-3360
- NPI assigned
- Jan 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | LCSW5402 | CA | Primary |
Addresses
Primary practice location
21 Castle LN
Oakland, CA 94611-2743
Mailing address
21 Castle LN
Oakland, CA 94611-2743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW5402 | CA | MD | Psychoanalyst |
| 5402 | CA | MD | Mobile Radiology Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390780800000",
"number": "1083037089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 CASTLE LN",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946112743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 CASTLE LN",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946112743",
"telephone_number": "510-482-3360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "LAURIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-27",
"last_updated": "2014-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "CA",
"license": "LCSW5402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.