Healthcare Provider Details

I. General information

NPI: 1659094761
Provider Name (Legal Business Name): AMY ANGELA STEWARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 W SONORA ST
STOCKTON CA
95203-3329
US

IV. Provider business mailing address

PO BOX 779
STOCKTON CA
95201-0779
US

V. Phone/Fax

Practice location:
  • Phone: 209-337-3298
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95020116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: