Dejsa Edwards, SUDRC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

19113 Issued in CA

Practice address

9920 Pacific Heights Blvd
Suite 150
San Diego, CA 92121-4396

Phone

(303) 989-8169

NPI assigned

Jan 19, 2023

Reactivated

Dec 29, 2023

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1396450714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HOTEL CIR N STE 314",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082803",
            "telephone_number": "619-759-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 PACIFIC HEIGHTS BLVD",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214396",
            "telephone_number": "303-989-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DEJSA",
        "credential": "SUDRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "deactivation_date": "2023-12-18",
        "reactivation_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "19113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adina Edwards
• Amber Edwards
• Ayesha J Edwards, LCSW, BCD
• Charles Fessenden Edwards, M.D.
• Crystal L Edwards
• Ellen E. Edwards, D.O.
• Haley Elizabeth Edwards, OTD OTR/L
• Jared Ray Edwards, MD
• Jessica Edwards
• Jessica Edwards, PHARM.D.

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.