Individual
DALLAS JAMES EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1545 HOTEL CIR S STE 300, SAN DIEGO, CA 92108-3414
(619) 549-0329
Mailing address
1545 HOTEL CIR S STE 300, SAN DIEGO, CA 92108-3414
(619) 549-0329
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APCC11789
CA
101YP2500X
Professional Counselor
Primary
APCC11789
CA
101YP2500X
Professional Counselor
Primary
LPCC21772
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2021
Last updated
03/25/2026
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