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General NPI Number Information
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NPI Number | 1740143221
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Entity Type | Individual
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Provider Name | JOHN WILLIAM EDWARDS III
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Gender | Male
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 7918 EL CAJON BLVD STE N #113
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City | LA MESA
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State | CA
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Zip | 91942-6710
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Country | US
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Telephone | 619-891-2887
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Fax |
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Provider Business Mailing Address
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Address Line | 7918 EL CAJON BLVD STE N #113
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City | LA MESA
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State | CA
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Zip | 91942-6710
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Country | US
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Telephone |
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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 | 132932
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License Number State | CA
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