Individual provider Active NPI

Andrea Michelle Stewart, MFT

  • Marriage & Family Therapist
  • Lemon Grove, CA
National Provider Identifier
1508993122
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
45174 Issued in CA
Practice address
2741 Lemon Grove Ave
#103
Lemon Grove, CA 91945-2975
Phone
(619) 713-0258
Fax
(619) 713-1365
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 45174 CA Primary

Addresses

Primary practice location

2741 Lemon Grove Ave
#103
Lemon Grove, CA 91945-2975

Mailing address

2741 Lemon Grove Ave Ste 103
Lemon Grove, CA 91945-2976
Phone (619) 713-0258

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

LicenseStateTypeSpecialty
45174CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1508993122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 LEMON GROVE AVE STE 103",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452976",
            "telephone_number": "619-713-0258",
            "fax_number": "619-713-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 LEMON GROVE AVE",
            "address_2": "#103",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919452975",
            "telephone_number": "619-713-0258",
            "fax_number": "619-713-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemon Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.