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NPI Code Detail

MEDICARE: KAMERON EDWARDS

MEDICARE: KAMERON EDWARDS
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
1103TC1900XCounseling Psychologist
2103TF0000XFamily Psychologist
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1801395009
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMERON EDWARDS
Provider Business Mailing Address
First Line : 5826 OCCIDENTAL ST
Second Line :
City : EMERYVILLE
State : CA
Zip : 94608-2328
Country : US
Telephone Number : 510-452-7799
Fax Number :
Provider Business Practice Location Address
First Line : 2325 CLEMENT AVE STE A
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-7061
Country : US
Telephone Number : 510-629-6377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2018
Last Update Date : 09/01/2021

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Directions to “ KAMERON EDWARDS ” Practice Location

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