Jeremiah Edwards, LPT

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

36785 Issued in CA

Practice address

3881 S Western Ave
2500 Wilshire Blvd Suite 500
Los Angeles, CA 90062-1105

Phone

(213) 639-0251

Fax

(213) 389-7358

NPI assigned

Apr 25, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1124462734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S GAREY AVE SPC 61",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665260",
            "telephone_number": "909-272-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3881 S WESTERN AVE",
            "address_2": "2500 WILSHIRE BLVD SUITE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621105",
            "telephone_number": "213-639-0251",
            "fax_number": "213-389-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JEREMIAH",
        "credential": "LPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "36785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Dale Edwards, M.S. CCC-A
• Esme Edwards
• Irv Edward Edwards, M.D.
• Jay Edwards, MFT
• Jennifer Marie Edwards, PA-C
• Juliana Edwards
• Kendall Dwayne Edwards
• Kevonn Marquis Edwards
• Krystle Edwards
• Lisa Edwards

• Licensed Psychiatric Technician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.