Healthcare Provider Details

I. General information

NPI: 1508797622
Provider Name (Legal Business Name): KILA LEI STEWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 W TEFFT ST
NIPOMO CA
93444-9624
US

IV. Provider business mailing address

2541 RUDDER RD
OCEANSIDE CA
92054-6163
US

V. Phone/Fax

Practice location:
  • Phone: 805-474-3790
  • Fax:
Mailing address:
  • Phone: 760-815-5671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: