Provider Demographics
NPI:1902677826
Name:UMADA, EDWARD JR (MSW)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:UMADA
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 LA JOLLA WAY
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2232
Mailing Address - Country:US
Mailing Address - Phone:209-201-7479
Mailing Address - Fax:
Practice Address - Street 1:902 LA JOLLA WAY
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2232
Practice Address - Country:US
Practice Address - Phone:209-201-7479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1194811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical