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General NPI Number Information
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NPI Number | 1528198744
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Entity Type | Individual
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Provider Name | JASON EDGAR PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 8856 ARLINGTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92503-1365
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Country | US
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Telephone | 833-867-4642
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Fax | 360-462-5824
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Provider Business Mailing Address
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Address Line | 4436 CALLE REAL
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City | SANTA BARBARA
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State | CA
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Zip | 93110-1002
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Country | US
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Telephone | 951-751-4127
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY28090
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License Number State | CA
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