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General NPI Number Information
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NPI Number | 1366594871
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Entity Type | Individual
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Provider Name | KENNETH B. STEWART MSW
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 3000 AUBURN BLVD SUITE A
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City | SACRAMENTO
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State | CA
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Zip | 95821-1831
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Country | US
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Telephone | 916-483-2154
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Fax | 916-483-2850
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Provider Business Mailing Address
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Address Line | 3000 AUBURN BLVD SUITE A
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City | SACRAMENTO
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State | CA
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Zip | 95821-1831
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Country | US
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Telephone | 916-483-2154
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Fax | 916-483-2850
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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 | LCS28454
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 137036-3501
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801079748
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License Number State | MI
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