Provider Demographics
NPI:1134543200
Name:STEWART, PAULA DENISE
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:DENISE
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 MARKET ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5402
Mailing Address - Country:US
Mailing Address - Phone:415-252-3893
Mailing Address - Fax:415-252-3910
Practice Address - Street 1:1390 MARKET ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5402
Practice Address - Country:US
Practice Address - Phone:415-252-3893
Practice Address - Fax:415-252-3910
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6393174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist