Provider Demographics
NPI:1942428289
Name:NIXON, STEWART B (STEWART B NIXON)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:B
Last Name:NIXON
Suffix:
Gender:M
Credentials:STEWART B NIXON
Other - Prefix:DR
Other - First Name:STEWART
Other - Middle Name:B
Other - Last Name:NIXON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:1515 THE ALAMEDA STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2321
Mailing Address - Country:US
Mailing Address - Phone:408-287-2103
Mailing Address - Fax:650-322-2689
Practice Address - Street 1:1515 THE ALAMEDA STE 202
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2321
Practice Address - Country:US
Practice Address - Phone:408-287-2103
Practice Address - Fax:650-322-2689
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 3162103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral