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General NPI Number Information
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NPI Number | 1427361955
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Entity Type | Individual
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Provider Name | AYESHA J EDWARDS LCSW, BCD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 2730 MCKEAN ST BLDG 291
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City | SAN DIEGO
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State | CA
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Zip | 92136-5000
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Country | US
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Telephone | 619-556-8449
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Fax |
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Provider Business Mailing Address
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Address Line | NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DR, DMS SOCIAL WORK DEPARTMENT
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City | SAN DIEGO
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State | CA
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Zip | 92134-5000
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Country | US
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Telephone | 619-453-4399
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-3886
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License Number State | HI
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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 | BCD-59139
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 75552
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License Number State | CA
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