Provider Demographics
NPI:1639292139
Name:STEWART, KATHRYN RHODY (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:RHODY
Last Name:STEWART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 BOWLING GREEN DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4504
Mailing Address - Country:US
Mailing Address - Phone:925-377-2029
Mailing Address - Fax:925-377-2028
Practice Address - Street 1:3093 CITRUS CIR
Practice Address - Street 2:SUITE 170
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2687
Practice Address - Country:US
Practice Address - Phone:925-788-1258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11563103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent