Provider Demographics
NPI:1437459849
Name:BURTON, STEPHANIE NICHOLE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:NICHOLE
Last Name:BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:NICHOLE
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0400
Mailing Address - Country:US
Mailing Address - Phone:530-527-8491
Mailing Address - Fax:530-527-0232
Practice Address - Street 1:1860 WALNUT ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3611
Practice Address - Country:US
Practice Address - Phone:530-527-5631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No104100000XBehavioral Health & Social Service ProvidersSocial Worker