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Tatiana Geneva Stewart

Social Worker

Behavioral Health & Social Service Providers

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

PECOS Enrollment

This provider is enrolled in PECOS as TATIANA STEWART.

Based on the most recent information from CMS, provider Tatiana Geneva Stewart is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1912159906
Provider Type
Individual
Full Name
Stewart, Tatiana Geneva
Title
Ms.
Credential
LCSW85755

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/21/2008
Last Updated
12/18/2019

Contact Information

Practice Location

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

(510) 368-5068

Unlisted Fax

Mailing Location

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

(510) 368-5068

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 85755 California
Code 101Y00000X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License ASW60343 California

Tatiana Geneva Stewart

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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