| John Roderick Edwards, A Licensed Clinical Social Worker Corporation | |
|
2939 Summit St Ste 203 Oakland CA 94609-3404 | |
| (510) 213-9284 | |
| (510) 285-6457 |
| Full Name | John Roderick Edwards, A Licensed Clinical Social Worker Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2939 Summit St Ste 203, Oakland, California |
| Authorized Official Name and Position | John Roderick Edwards (PRESIDENT) |
| Authorized Official Contact | 5102139284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Roderick Edwards, A Licensed Clinical Social Worker Corporation Po Box 491 Oakland CA 94604-0491 Ph: (510) 213-9284 | John Roderick Edwards, A Licensed Clinical Social Worker Corporation 2939 Summit St Ste 203 Oakland CA 94609-3404 Ph: (510) 213-9284 |
| NPI Number | 1629782339 |
|---|---|
| Provider Enumeration Date | 01/09/2023 |
| Last Update Date | 01/09/2023 |
| Certification Date | 01/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629782339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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