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General NPI Number Information
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NPI Number | 1598075111
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Entity Type | Individual
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Provider Name | JOSEPH EDWARDS IMF
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Gender | Male
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Dates
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Enumeration Date | 10/15/2010
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 5555 RESERVOIR DR STE 309
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City | SAN DIEGO
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State | CA
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Zip | 92120-5193
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Country | US
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Telephone | 619-504-0786
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 DORSIE LN
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City | LA MESA
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State | CA
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Zip | 91941-7335
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Country | US
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Telephone | 619-504-0786
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF 64400
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 87660
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License Number State | CA
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