Provider Demographics
NPI:1962294686
Name:STEWART-ENEH, ANTOINETTE CLARE
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:CLARE
Last Name:STEWART-ENEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3738 DEGNAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-4017
Mailing Address - Country:US
Mailing Address - Phone:909-926-8596
Mailing Address - Fax:
Practice Address - Street 1:3738 DEGNAN BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-4017
Practice Address - Country:US
Practice Address - Phone:909-926-8596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty