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General NPI Number Information
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NPI Number | 1477816627
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Entity Type | Individual
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Provider Name | MR. LUKE ALAN STUARD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 629 N MAIN ST
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City | CORONA
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State | CA
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Zip | 92880-1409
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Country | US
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Telephone | 951-738-4850
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Fax |
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Provider Business Mailing Address
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Address Line | 6020 BOSWELL CT
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City | RIVERSIDE
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State | CA
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Zip | 92507-8416
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Country | US
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Telephone | 951-961-4562
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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