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General NPI Number Information
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NPI Number | 1124794052
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Entity Type | Individual
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Provider Name | MRS. CAROLINA STEWART
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Gender | Female
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 18321 CLARK ST
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City | TARZANA
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State | CA
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Zip | 91356-3501
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Country | US
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Telephone | 818-609-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 15818 SHERMAN WAY APT 3
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City | VAN NUYS
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State | CA
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Zip | 91406-4036
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Country | US
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Telephone | 818-536-3689
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Fax |
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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 | ASW97925
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License Number State | CA
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