Doctor Name: | DR. CURTIS JAY EDWARDS |
NPI Number: | 1417075094 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY21240 |
Business Practice Address: | 3766 Calle Mazatlan Newbury Park, CA - 913205044 |
Business Phone Number: | 8052081373 |
Business Fax Number: | |
Mailing Address: | 3766 Calle Mazatlan, NEWBURY PARK |
State: | CA |
Postal Code: | 913201949 |
Phone Number: | 8052081373 |
Fax Number: | |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 04/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY21240 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |