Christopher Edmonds, R1476250722

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

9826 18TH Ave
Blythe, CA 92225-9229

Phone

(619) 586-4930

NPI assigned

Aug 1, 2022

Sex

Male

Sole proprietor

No

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

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1972239986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103524",
            "telephone_number": "619-586-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9826 18TH AVE",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922259229",
            "telephone_number": "619-586-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDS",
        "first_name": "CHRISTOPHER",
        "credential": "R1476250722",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David DO, DMD
• Gregory C. Doane, MD
• Frank Wayne Dudley Jr.
• David (None) Dunn, M.D.
• Khashayar Ebrahimzadeh, MD
• Rochella Edwards
• Epifania V Nicolas
• Epifania V Nicolas DDS Inc
• Epifania V Nicolas DDS Inc.
• Domenic J Errico, MPT

• Addiction (Substance Use Disorder) Counselor in Blythe, CA
• Providers in Blythe, 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 Dec 27, 2023; 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.