Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Autumn Fawn Stewart Luckey

Individual provider Community Health Worker · NPI 1164047510

Autumn Fawn Stewart Luckey is a Community Health Worker in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

11303 W Washington Blvd Ste 200
Los Angeles, CA 90066-6003
Phone: (310) 482-6600
Fax: (310) 313-0973
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X
Rehabilitation Practitioner Taxonomy 225400000X (CA)

Record details

NPI number1164047510
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 11, 2020
Last updated in NPPESMay 8, 2025
Certification dateMay 8, 2025

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