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General NPI Number Information
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NPI Number | 1053235424
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Entity Type | Individual
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Provider Name | DEVINA JEWELL EIDSON PPS
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Gender | Female
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 3222 WINONA WAY
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City | NORTH HIGHLANDS
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State | CA
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Zip | 95660-5523
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Country | US
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Telephone | 916-566-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 7223 LEE DEFOREST DR
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City | COLUMBIA
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State | MD
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Zip | 21046-3236
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Country | US
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Telephone | 813-829-0772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 220163340
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License Number State | CA
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