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General NPI Number Information
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NPI Number | 1801669718
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Entity Type | Individual
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Provider Name | DESIREE CARLOTTA EDMONDS AMFT, APCC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 2035 E BALL RD STE 200
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City | ANAHEIM
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State | CA
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Zip | 92806-5157
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Country | US
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Telephone | 714-517-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 10740 BROOKFIELD DRIVE
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City | RIVERSIDE
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State | CA
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Zip | 92505
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Country | US
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Telephone | 909-485-4545
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14997
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 142380
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License Number State | CA
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