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JACK DUANE EDMONDSON LCSW
NPI 1093987166
Social Worker - Clinical in Poway, CA

Active since March 29, 2008
14207 KENDRA WAY, POWAY, CA 92064(858) 748-7093 Get Directions Write a Review

NPPES record last updated: March 29, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack Duane Edmondson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK DUANE EDMONDSON LCSW (NPI 1093987166) is an individual clinical provider in Poway, California, licensed in California (1903) and active in the NPI registry since March 2008.

NPPES Registry Identity

NPI1093987166
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJACK DUANE EDMONDSONCredential: LCSW
Location Address14207 KENDRA WAYPoway, CA 92064-3330
Mailing Address14207 Kendra WayPoway, CA 92064-3330 · (858) 748-7093
Phone(858) 748-7093
Sole ProprietorYes
Enumeration DateMarch 29, 2008
✔ NPI 1093987166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 1903
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
14207 KENDRA WAY, Poway, CA 92064
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Edmondson's NPI number?

The NPI number for Jack Edmondson is 1093987166. It was assigned to this individual provider in the NPPES registry on March 29, 2008.

Where is Jack Edmondson located?

Jack Edmondson practices at 14207 Kendra Way, Poway, CA 92064. The listed phone number is (858) 748-7093.

What is Jack Edmondson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jack Edmondson was last updated on March 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.