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JIMMY EDGEWORTH
NPI 1790908671
Counselor in Stockton, CA

Active since April 10, 2007
1117 S GRANT ST, STOCKTON, CA 95206(209) 461-6500 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jimmy Edgeworth NPPES

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

JIMMY EDGEWORTH (NPI 1790908671) is an individual counselor in Stockton, California and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1790908671
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameJIMMY EDGEWORTH
Location Address1117 S GRANT STStockton, CA 95206-1626
Mailing Address8210 S Bright RdFrench Camp, CA 95231-9759 · (209) 461-6500
Phone(209) 461-6500
Sole ProprietorNo
Enumeration DateApril 10, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1790908671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

1117 S GRANT ST, Stockton, CA 95206
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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAMELA JONES
Counselor
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (209) 461-6500
STEVEN DERR
Counselor
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (209) 461-6500
AWANDA BROWNLEE
Counselor
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (209) 461-6500
SUSAN ADAMES
Counselor
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (209) 461-6500
GODS LOVE OUTREACH MINISTRIES
Community Based Residential Treatment Facility, Mental Illness
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (925) 570-3282
DR. CRYSTAL ROSE KRULL PSYD
Psychologist (Clinical)
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (916) 955-9984
RICHARD DEPRICE DAVIS
Day Training/Habilitation Specialist
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (925) 321-9236
KAREN LYNETTE EDMOND
Day Training/Habilitation Specialist
1117 S GRANT ST
STOCKTON, CA 95206
San Joaquin County (925) 579-4018

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 Jimmy Edgeworth's NPI number?

The NPI number for Jimmy Edgeworth is 1790908671. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is Jimmy Edgeworth located?

Jimmy Edgeworth practices at 1117 S Grant St, Stockton, CA 95206. The listed phone number is (209) 461-6500.

What is Jimmy Edgeworth's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Jimmy Edgeworth was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.