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NPI Code Detail

MEDICARE: LISA JANELLE STEWART

MEDICARE: LISA JANELLE STEWART
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
1171M00000XCase Manager/Care Coordinator
2225400000XRehabilitation Practitioner
3373H00000XDay Training/Habilitation Specialist
4172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1598849143
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA JANELLE STEWART
Provider Business Mailing Address
First Line : 3850 CRENSHAW BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-1821
Country : US
Telephone Number : 322-751-3026
Fax Number :
Provider Business Practice Location Address
First Line : 3850 CRENSHAW BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-1821
Country : US
Telephone Number : 322-751-3026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 06/24/2025

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Directions to “ LISA JANELLE STEWART ” Practice Location

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