Active NPI
Antwanette Elizabeth Edwards
- Social Worker
- Pleasant Hill, CA
National Provider Identifier
1124785134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 2387 Lisa LN
Pleasant Hill, CA 94523-3949 - Phone
- (925) 677-7480
- NPI assigned
- Nov 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
2387 Lisa LN
Pleasant Hill, CA 94523-3949
Mailing address
136 Valdivia Cir
San Ramon, CA 94583-2228
Other practice location 1
136 Valdivia Cir
San Ramon, CA 94583-2228
Phone (407) 462-5593
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paradise Adolescent Home | Mental Health | Current | 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": "1637712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1124785134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 VALDIVIA CIR",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945832228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2387 LISA LN",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945233949",
"telephone_number": "925-677-7480"
}
],
"practiceLocations": [
{
"address_1": "136 Valdivia Cir",
"address_purpose": "LOCATION",
"city": "San Ramon",
"state": "CA",
"postal_code": "945832228",
"country_code": "US",
"telephone_number": "407-462-5593",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EDWARDS",
"first_name": "ANTWANETTE",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-24",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Hill, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.