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General NPI Number Information
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NPI Number | 1821913088
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Entity Type | Individual
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Provider Name | EFFIE ELIZABETH EDWARDS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 1420 S CENTRAL AVE
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City | GLENDALE
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State | CA
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Zip | 91204-2508
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Country | US
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Telephone | 818-952-2362
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 HUNTINGTON DR
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-4924
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Country | US
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Telephone | 479-200-6240
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95041014
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License Number State | CA
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