Active NPI
Sydney Shanel Stewart
- Assistant Behavior Analyst
- Ontario, CA
National Provider Identifier
1114356797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 1114356797
- Practice address
- 2990 Inland Empire Blvd Ste 100&101
Ontario, CA 91764-4899 - Phone
- (909) 295-8692
- NPI assigned
- Nov 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 1114356797 | CA | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
2990 Inland Empire Blvd Ste 100&101
Ontario, CA 91764-4899
Mailing address
PO Box 740780
Atlanta, GA 30374-0780
Phone (855) 223-7123
Other practice location 1
9942 Svl Box
Victorville, CA 92395-5144
Phone (909) 413-1561
Other practice location 2
850 E Desert Inn Rd
Apt #505
Las Vegas, NV 89109-9382
Phone (909) 703-0683
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114356797 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1114356797 | CA | MD | Assistant Behavior Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781568000000",
"number": "1114356797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 740780",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303740780",
"telephone_number": "855-223-7123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2990 INLAND EMPIRE BLVD STE 100&101",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917644899",
"telephone_number": "909-295-8692"
}
],
"practiceLocations": [
{
"address_1": "9942 Svl Box",
"address_purpose": "LOCATION",
"city": "Victorville",
"state": "CA",
"postal_code": "923955144",
"country_code": "US",
"telephone_number": "909-413-1561",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "850 E Desert Inn Rd",
"address_2": "Apt #505",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891099382",
"country_code": "US",
"telephone_number": "909-703-0683",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEWART",
"first_name": "SYDNEY",
"middle_name": "SHANEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-05",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "CA",
"license": "1114356797",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1114356797",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.