Individual provider Active NPI

Brooke Nichole Stewart-Hardin, M.A.

  • Marriage & Family Therapist
  • Hesperia, CA
National Provider Identifier
1659632636
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
70883 Issued in CA
Practice address
11951 Hesperia Rd
Hesperia, CA 92345-1855
Phone
(760) 956-2345
NPI assigned
Jun 6, 2012
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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 70883 CA Primary

Addresses

Primary practice location

11951 Hesperia Rd
Hesperia, CA 92345-1855

Mailing address

11951 Hesperia Rd
Hesperia, CA 92345-1855
Phone (760) 956-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240520001921 CA Practitioner - Marriage and Family Therapist 3678915873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
70883CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Apr 7, 2024 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1659632636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11951 HESPERIA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451855",
            "telephone_number": "760-956-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11951 HESPERIA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451855",
            "telephone_number": "760-956-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART-HARDIN",
        "first_name": "BROOKE",
        "middle_name": "NICHOLE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "70883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hesperia, CA

Sources for this page

Verify at the official NPI Registry.