Provider Demographics
NPI:1053549576
Name:STEWART PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:STEWART PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:559-224-2286
Mailing Address - Street 1:1322 E SHAW AVE STE 345
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7904
Mailing Address - Country:US
Mailing Address - Phone:559-224-2286
Mailing Address - Fax:559-224-2286
Practice Address - Street 1:1322 E SHAW AVE STE 345
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7904
Practice Address - Country:US
Practice Address - Phone:559-323-7263
Practice Address - Fax:559-323-8077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21346103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty