MEDICARE: DR. DAVID L STEWART PH.D.

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	103G00000X	Clinical Neuropsychologist	PSY 13088	CA
2	103T00000X	Psychologist	PSY 13088	CA

General Provider Information

NPI Number	:	1699881201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID L STEWART PH.D.

Provider Business Mailing Address
First Line	:	970 CAMERADO DR
Second Line	:	SUITE 203
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-7636
Country	:	US
Telephone Number	:	530-676-7091
Fax Number	:	530-676-7092

Provider Business Practice Location Address
First Line	:	970 CAMERADO DR
Second Line	:	SUITE 203
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-7636
Country	:	US
Telephone Number	:	530-676-7091
Fax Number	:	530-676-7092

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	09/11/2025

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