Provider Demographics
NPI:1952542136
Name:STEWART, KAREN M (PSY D)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:STEWART
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1803
Mailing Address - Country:US
Mailing Address - Phone:310-477-6000
Mailing Address - Fax:310-477-0327
Practice Address - Street 1:3201 WILSHIRE BLVD
Practice Address - Street 2:STE 320
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2335
Practice Address - Country:US
Practice Address - Phone:310-477-6000
Practice Address - Fax:310-477-0327
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22580103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical