Provider Demographics
NPI:1629380662
Name:STEWART, JOSHUA WADE
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:WADE
Last Name:STEWART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WADE
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21918 BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:PALO CEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:96073-8738
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2135 PINE ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2690
Practice Address - Country:US
Practice Address - Phone:530-722-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No253J00000XAgenciesFoster Care Agency