Provider Demographics
NPI:1164261780
Name:STEWARD, ROZALIE ENRIQUEZ (FNP)
Entity type:Individual
Prefix:
First Name:ROZALIE
Middle Name:ENRIQUEZ
Last Name:STEWARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 W I ST
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-2527
Mailing Address - Country:US
Mailing Address - Phone:704-582-9859
Mailing Address - Fax:
Practice Address - Street 1:1777 BOTELHO DR STE 240
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5083
Practice Address - Country:US
Practice Address - Phone:408-900-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily