Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack Duane Edmondson, LCSW

Individual provider Clinical Social Worker · NPI 1093987166

Jack Duane Edmondson, LCSW is a Clinical Social Worker in Poway, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2008
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

14207 Kendra Way
Poway, CA 92064-3330
Phone: (858) 748-7093
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 1903 (CA)

Record details

NPI number1093987166
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 29, 2008
Last updated in NPPESMarch 29, 2008

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