Provider Demographics
NPI:1356482871
Name:STEWART, JOHN HOWARD (MFT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HOWARD
Last Name:STEWART
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 TAYLORVILLE RD.
Mailing Address - Street 2:STE. 206
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949
Mailing Address - Country:US
Mailing Address - Phone:530-272-7448
Mailing Address - Fax:530-272-9904
Practice Address - Street 1:908 TAYLORVILLE RD.
Practice Address - Street 2:STE. 206
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949
Practice Address - Country:US
Practice Address - Phone:530-272-7448
Practice Address - Fax:530-272-9904
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30487106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist