Individual provider Active NPI

Milena Edwards, PSY.D.

  • Clinical Psychologist
  • Oakland, CA
National Provider Identifier
1952559627
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24397 Issued in CA
Practice address
5655 College Ave
316C
Oakland, CA 94618-1583
Phone
(510) 273-9229
NPI assigned
Sep 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY24397 CA Primary

Addresses

Primary practice location

5655 College Ave
316C
Oakland, CA 94618-1583

Mailing address

5655 College Ave
316C
Oakland, CA 94618-1583
Phone (510) 273-9229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 5, 2023 through Dec 5, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY24397CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1952559627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5655 COLLEGE AVE",
            "address_2": "316C",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181583",
            "telephone_number": "510-273-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5655 COLLEGE AVE",
            "address_2": "316C",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181583",
            "telephone_number": "510-273-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MILENA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.