Provider Demographics
NPI:1699561365
Name:STEWART, DJUANNA LASHEA
Entity type:Individual
Prefix:
First Name:DJUANNA
Middle Name:LASHEA
Last Name:STEWART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ADAMS RANCH RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-2621
Mailing Address - Country:US
Mailing Address - Phone:510-504-7504
Mailing Address - Fax:
Practice Address - Street 1:1006 VICTORIA PARK
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-2626
Practice Address - Country:US
Practice Address - Phone:510-504-7504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1697759106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician