Nicole F Edwards

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

115963 Issued in CA

Practice address

400 Estudillo Ave
San Leandro, CA 94577-4999

Phone

(510) 352-9200

Fax

(510) 352-3120

NPI assigned

Feb 14, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Subacute Treatment for Adolescent Rehabilitation Services, Inc.

  • Community/Behavioral Health Agency
  • San Leandro, CA
  • NPI 1184748915
  NPD
• Subacute Treatment for Adolescent Rehabilitation Services, Inc.

  • Community/Behavioral Health Agency
  • San Leandro, CA
  • NPI 1205992096
  NPD

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1568735082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774999",
            "telephone_number": "510-352-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774999",
            "telephone_number": "510-352-9200",
            "fax_number": "510-352-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "NICOLE",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "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": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "115963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Edmunds1
• Imafidon George Edogun, M.D.
• Sunday Edogun
• Dana Michelle Edwards
• Elizabeth Bartolomeo Edwards, C.N.M.
• Susan Carole Eile, M.D.
• Karthik Ekambaram
• Ajiri Victoria Ekpebe
• Carina Elenes
• Judy Elkan

• Marriage & Family Therapist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.