EDGE WOOD (NPI# 1528386117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528386117 |
Entity Type | Organization |
Organization Name | EDGE WOOD |
Practice Address |
1801 Vicente Street San Francisco CA 94116 |
Practice Telephone | 4156813205 |
Mailing Telephone | 4156813205 |
Enumeration Date | 2010-05-07 |
Last Update Date | 2010-05-07 |
Authorized Official Name | MICHAEL NATHEN PICKARD (COUNSELOR) |
Authorized Official Telephone | 4154188409 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
New York State Corporations | EDGE WOOD CONTRACTING OF LI, INC. | 7 Elmay Place, East Northport, Ny 11731 |
Vermont Business Registrations | EDGE WOODWORKS LLC | 837 Dewing Rd, Franklin, VT 05457 |
Street Address |
1801 VICENTE STREET |
City | SAN FRANCISCO |
State | CA |
Zip Code | 94116 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891899183 | Robin Ricardo Randall | Psychiatry & Neurology | 1801 Vicente Street, The Edgewood Center for Children and Families, San Francisco, CA 94116-2923 | 2006-09-08 |
1053926139 | Abdulmalik Alturki | Student in an Organized Health Care Education/Training Program | 1801 Vicente Street, San Francisco, CA 94116 | 2020-09-15 |
1902322522 | Simon Lam | Community Health Worker | 1801 Vicente Street, San Francisco, CA 94116 | 2017-08-15 |
1841747375 | Romuald Kai Santiago | Community Health Worker | 1801 Vicente Street, San Francisco, CA 94116 | 2016-09-01 |
1083038079 | Carmen Smith | Community Health Worker | 1801 Vicente Street, San Francisco, CA 94116 | 2014-02-11 |
1679903520 | Rebecca Mars | Community Health Worker | 1801 Vicente Street, San Francisco, CA 94116 | 2013-11-13 |
1568802643 | Robert Belmore | Counselor | 1801 Vicente Street, San Francisco, CA 94116 | 2013-07-03 |
1023363793 | Luis Gerardo Cortes | Counselor | 1801 Vicente Street, San Francisco, CA 94116 | 2012-07-19 |
1235423880 | Omoh Debbie Odiye | Counselor | 1801 Vicente Street, San Francisco, CA 94116 | 2011-05-31 |
1730499773 | Jill Suzanne Mcroberts | Counselor | 1801 Vicente Street, San Francisco, CA 94116-2995 | 2010-10-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386275972 | Eric Lee | Behavior Technician | 2000 43rd Ave, San Francisco, CA 94116 | 2020-01-31 |
1376103176 | Young-in Kim | Physical Therapist | 3401 Taraval St, San Francisco, CA 94116 | 2019-06-14 |
1952806408 | Ramirez & Xia Dental Corp. | Dentist | 2409 Taraval St., San Francisco, CA 94116 | 2018-03-27 |
1043739337 | Cindi Lam | Community Health Worker | 375 Laguna Honda Blvd., B200, San Francisco, CA 94116 | 2017-09-18 |
1043735442 | Tammy Marie Buhler | Community Health Worker | 1990 41st Avenue, San Francisco, CA 94116 | 2017-08-07 |
1457875015 | Janet Bilafer-steiner | Nurse Practitioner | 2935 Travel Street, San Francisco, CA 94116 | 2017-07-26 |
1790225811 | Christopher Valles-martinez | Counselor | 1801 Vicente St, San Francisco, CA 94116 | 2017-03-08 |
1033659578 | Emiko Perez | Technician, Other | 2235 31st Ave, San Francisco, CA 94116 | 2017-03-02 |
1982070249 | Elizabeth Ancker | Counselor | 1800 Vicente Street, San Francisco, CA 94116 | 2015-08-20 |
1922432608 | Toby Wai Chang | Pharmacist | 2354 32nd Ave, San Francisco, CA 94116 | 2013-08-29 |
Find all providers in zip 94116 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134650070 | Nalls Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-03-22 |
1568742823 | Edgewood Center | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente Ave, San Francisco, CA 94116 | 2011-08-18 |
1942469705 | Jory Daniel Linzer Zalona | Residential Treatment Facility, Emotionally Disturbed Children | 1814 Divisadero St, San Francisco, CA 94115-2517 | 2008-06-06 |
1093973679 | Amanda Marie Oswalt | Residential Treatment Facility, Emotionally Disturbed Children | 1062 Fulton St Apt 2, San Francisco, CA 94117-1627 | 2008-05-30 |
1043626617 | Samantha Mccants | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2014-07-03 |
1265865240 | Edgewood | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2013-08-14 |
1235365883 | Noam Scott | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2009-06-09 |
1932341716 | Edgewood Center | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2009-03-25 |
1801056395 | Edgewood | Residential Treatment Facility, Emotionally Disturbed Children | 1801 Vicente St, San Francisco, CA 94116-2923 | 2008-06-10 |
1639340573 | Burt Childrens Center | Residential Treatment Facility, Emotionally Disturbed Children | 940 Grove St, San Francisco, CA 94117-1714 | 2008-03-19 |
Find all providers in SAN FRANCISCO |
City | SAN FRANCISCO |
Zip Code | 94116 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.