Provider Demographics
NPI:1487539631
Name:EDWARDS, JENNIFER MONIQUE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MONIQUE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MONIQUE
Other - Last Name:ACEBEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4065 AZURITA CT
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-8654
Mailing Address - Country:US
Mailing Address - Phone:951-264-6380
Mailing Address - Fax:951-264-6380
Practice Address - Street 1:4065 AZURITA CT
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-8654
Practice Address - Country:US
Practice Address - Phone:951-264-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker