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General NPI Number Information
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NPI Number | 1730660853
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Entity Type | Individual
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Provider Name | EDWARD LEE WELLS LEP, LMFT
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Gender | Male
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 27035 WHITMAN ST
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City | HAYWARD
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State | CA
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Zip | 94544-4027
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Country | US
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Telephone | 510-723-3190
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Fax | 510-582-0964
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Provider Business Mailing Address
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Address Line | 24411 AMADOR ST
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City | HAYWARD
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State | CA
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Zip | 94544-1301
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Country | US
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Telephone | 510-784-2611
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Fax | 510-784-2629
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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 | 87423
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 3212
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License Number State | CA
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