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General NPI Number Information
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NPI Number | 1033322565
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Entity Type | Individual
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Provider Name | PHYLLIS K STEWART LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15300 VENTURA BLVD SUITE 408
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3103
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Country | US
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Telephone | 818-789-7728
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Fax | 323-466-0547
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Provider Business Mailing Address
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Address Line | 5513 RIDGE OAK DR
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City | LOS ANGELES
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State | CA
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Zip | 90068-2553
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Country | US
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Telephone | 818-789-7728
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Fax | 323-466-0547
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS05270
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License Number State | CA
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