=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891110078
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEX MARIE STEWART MS, CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2014
-----------------------------------------------------
Last Update Date | 04/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1160 SUNCAST LN STE 9
-----------------------------------------------------
City | EL DORADO HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95762-9327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-728-0757
-----------------------------------------------------
Fax | 530-728-0757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1620 PASO DIABLO ROAD
-----------------------------------------------------
City | PLACERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95667
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-728-0757
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 22500
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------