Provider Demographics
NPI:1124221775
Name:EDWARDS, VIRGINIA A (RAS)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3707
Mailing Address - Country:US
Mailing Address - Phone:510-236-3139
Mailing Address - Fax:510-236-3200
Practice Address - Street 1:3939 BISSELL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94805-2200
Practice Address - Country:US
Practice Address - Phone:510-215-2280
Practice Address - Fax:510-215-2283
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)