Provider Demographics
NPI:1477816627
Name:STUARD, LUKE ALAN
Entity Type:Individual
Prefix:MR
First Name:LUKE
Middle Name:ALAN
Last Name:STUARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 BOSWELL CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-8416
Mailing Address - Country:US
Mailing Address - Phone:951-961-4562
Mailing Address - Fax:
Practice Address - Street 1:629 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92880-1409
Practice Address - Country:US
Practice Address - Phone:951-738-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist