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General NPI Number Information
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NPI Number | 1053421297
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Entity Type | Individual
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Provider Name | EDWARD JOSEPH MCSHANE LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 1081 BORDEN RD SUITE 101
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City | ESCONDIDO
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State | CA
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Zip | 92026-2162
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Country | US
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Telephone | 760-745-1947
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Fax | 760-745-0357
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Provider Business Mailing Address
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Address Line | 135 E 3RD AVE STE B
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City | ESCONDIDO
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State | CA
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Zip | 92025-4252
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Country | US
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Telephone | 760-745-1947
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Fax | 760-745-0357
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW112929
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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