MEDICARE: MS. ELIZABETH JOY STEWART LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	96324	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3517	OTHER	CA	COUNTY

General Provider Information

NPI Number	:	1043387541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH JOY STEWART LMFT

Provider Business Mailing Address
First Line	:	4951 CHERRY AVE
Second Line	:	15
City	:	SAN JOSE
State	:	CA
Zip	:	95118-2768
Country	:	US
Telephone Number	:	408-375-3449
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 CAMDEN AVE
Second Line	:	15
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2942
Country	:	US
Telephone Number	:	408-800-7821
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	03/25/2017

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