Provider Demographics
NPI:1366795213
Name:EDELMAN, DEVRA M (MSW)
Entity type:Individual
Prefix:MS
First Name:DEVRA
Middle Name:M
Last Name:EDELMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1326
Mailing Address - Country:US
Mailing Address - Phone:415-409-2100
Mailing Address - Fax:415-345-0470
Practice Address - Street 1:1631 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1326
Practice Address - Country:US
Practice Address - Phone:415-409-2100
Practice Address - Fax:415-345-0470
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker