Individual
TYNISHA STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OQP
Contact information
Practice address
630 BERCUT DR STE C, SACRAMENTO, CA 95811-0110
(916) 363-1553
(916) 363-1638
Mailing address
3841 N FREEWAY BLVD STE 245, SACRAMENTO, CA 95834-1969
(916) 441-0226
(916) 441-0286
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
D2911902
CA
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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