Healthcare Provider Details

I. General information

NPI: 1588587596
Provider Name (Legal Business Name): KRISTA EDWARDS, LCSW THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10731 COLLETT AVE
RIVERSIDE CA
92505
US

IV. Provider business mailing address

9825 MAGNOLIA AVE SUITE B#382
RIVERSIDE CA
92503
US

V. Phone/Fax

Practice location:
  • Phone: 951-289-3440
  • Fax:
Mailing address:
  • Phone: 951-289-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTA LOUISE EDWARDS
Title or Position: THERAPIST/ BUSINESS OWNER
Credential: LCSW
Phone: 951-289-3440