Allie W. Edwards, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY 18234 Issued in CA

Practice address

1970 Broadway
Suite 835
Oakland, CA 94612

Phone

(510) 409-9238

Fax

(510) 727-9761

NPI assigned

Jun 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Pahma

  • Clinical Child & Adolescent Psychologist
  • Oakland, CA
  • NPI 1447024054
  NPD (past)

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1841492006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 BROADWAY",
            "address_2": "SUITE 835",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94612",
            "telephone_number": "510-409-9238",
            "fax_number": "510-727-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 BROADWAY",
            "address_2": "SUITE 835",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94612",
            "telephone_number": "510-409-9238",
            "fax_number": "510-727-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ALLIE",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 18234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edna Brewer Middle School
• Maisie Dee Edsall-Lingenfelter
• Education for Change Charter Public Schools
• Loree Eduvala
• Alanna Jeanne Edwards, MA
• Amy Louise Edwards
• Bobby Louis Edwards, RSAI, RCAS
• Charles Edwards, CHARLES EDWARDS
• Deborah Jacquelyn Edwards
• Dennis R. Edwards

• Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.