Individual
MS. DANA MICHELLE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3081 TEAGARDEN ST, SAN LEANDRO, CA 94577-5720
(510) 347-4620
Mailing address
981 JUANA AVE, SAN LEANDRO, CA 94577-5126
(510) 407-5630
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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