Provider Demographics
NPI:1235421215
Name:STEWART, MIIYOSHI ROGERS
Entity Type:Individual
Prefix:MS
First Name:MIIYOSHI
Middle Name:ROGERS
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 OAK ST STE 150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3064
Mailing Address - Country:US
Mailing Address - Phone:323-317-3743
Mailing Address - Fax:310-965-9791
Practice Address - Street 1:8019 S. COMPTON AVE.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001
Practice Address - Country:US
Practice Address - Phone:323-586-7333
Practice Address - Fax:310-965-9791
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10283225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty