Tatiana Geneva Stewart, LCSW85755

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

85755 Issued in CA

Practice address

1057 Macarthur Blvd Ste 208
San Leandro, CA 94577-3014

Phone

(510) 368-5068

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1912159906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 MACARTHUR BLVD STE 208",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773014",
            "telephone_number": "510-368-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 MACARTHUR BLVD STE 208",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945773014",
            "telephone_number": "510-368-5068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2275 Arlington Dr",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945781132",
            "country_code": "US",
            "telephone_number": "510-317-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TATIANA",
        "middle_name": "GENEVA",
        "name_prefix": "Ms.",
        "credential": "LCSW85755",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW60343",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "85755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "therapyrestoration@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Individual and Family Therapy",
            "address_1": "1057 MacArthur Blvd Ste 208",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945773014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carmen Stewart
• Kelli Karmen Stewart
• Keri Kamille Montesino Stewart
• Nishay Stewart
• Ruben Stewart
• John Joel Stienstra, DPM
• Jooske Annie Stil, MFT
• Donato Joseph Stinghen, MD
• Shelby Jade Stockmal
• Kelly Jean Stoering

• Clinical Social Worker in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.