Active NPI
Jessica Nicole Edwards
- Clinical Social Worker
- Riverside, CA
National Provider Identifier
1184587099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 134723
- Practice address
- 11801 Pierce St
Riverside, CA 92505-4408 - Phone
- (866) 478-3978
- NPI assigned
- Dec 8, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 134723 | CA | Primary |
Addresses
Primary practice location
11801 Pierce St
Riverside, CA 92505-4408
Mailing address
15105 Pasture Way
Victorville, CA 92394-7429
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
| License | State | Type | Specialty |
|---|---|---|---|
| 134723 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1184587099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15105 PASTURE WAY",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923947429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11801 PIERCE ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925054408",
"telephone_number": "866-478-3978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JESSICA",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-08",
"last_updated": "2025-12-08",
"certification_date": "2025-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "134723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.