Provider Demographics
NPI:1518410489
Name:STEWART, ELISABETH PARISH (LMFT)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:PARISH
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2359 MARVEL AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2214
Mailing Address - Country:US
Mailing Address - Phone:805-229-1996
Mailing Address - Fax:
Practice Address - Street 1:4505 LAS VIRGENES RD
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1956
Practice Address - Country:US
Practice Address - Phone:747-242-0853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90995106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist