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NPI Code Detail

MEDICARE: DONNA RAE EDWARDS CAADE

MEDICARE: DONNA RAE EDWARDS CAADE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker131590CA
2101YA0400XAddiction (Substance Use Disorder) Counselor
3171M00000XCase Manager/Care Coordinator
4171M00000XCase Manager/Care Coordinator131590CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740404284
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA RAE EDWARDS CAADE
Provider Business Mailing Address
First Line : 1563 MISSION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94103-2543
Country : US
Telephone Number : 415-762-3700
Fax Number : 415-865-0119
Provider Business Practice Location Address
First Line : 890 HAYES ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-2615
Country : US
Telephone Number : 415-762-3700
Fax Number : 415-865-0119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 06/24/2023

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Directions to “ DONNA RAE EDWARDS CAADE” Practice Location

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