Provider Demographics
NPI:1316009087
Name:STEWARD, PAMELA JOY (MS, LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JOY
Last Name:STEWARD
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 582
Mailing Address - Street 2:
Mailing Address - City:LITTLERIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95456-0582
Mailing Address - Country:US
Mailing Address - Phone:707-937-3672
Mailing Address - Fax:
Practice Address - Street 1:790 S FRANKLIN ST STE B
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:CA
Practice Address - Zip Code:95437-5456
Practice Address - Country:US
Practice Address - Phone:707-961-2707
Practice Address - Fax:707-961-2698
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health