Judith Edmundson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC7946 Issued in CA

Practice address

3624 Margaret Fowler CT
Chino Hills, CA 91709-5456

Phone

(909) 740-3133

Fax

(909) 306-5427

NPI assigned

Apr 2, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boys Republic

  • Mental Illness Community Based Residential Treatment Facility
  • Chino Hills, CA
  • NPI 1083305411
  NPD Authorized official

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1134625908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7902 SPRING HILL ST",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917087620",
            "telephone_number": "909-620-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 MARGARET FOWLER CT",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095456",
            "telephone_number": "909-740-3133",
            "fax_number": "909-306-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUNDSON",
        "first_name": "JUDITH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC7946",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC7946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Lauren Dunham, RDN
• Amoya Sharell Dunn
• Belle Duong
• Stacy Duruaku, LMFT
• Dylan Ross Eberhardt
• Lauren Eiges
• Carla Jean Ellett
• Ehab M Elmehey, P.T.
• Noureldeen Walid Elquza
• Shelby Olivia Elsasser, PA

• Professional Counselor in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.