Healthcare Provider Details

I. General information

NPI: 1003752551
Provider Name (Legal Business Name): STACY HAMPTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26846 CLAUDETTE ST
CANYON COUNTRY CA
91351-5220
US

IV. Provider business mailing address

24355 CREEKSIDE RD UNIT 800372
SANTA CLARITA CA
91380-7029
US

V. Phone/Fax

Practice location:
  • Phone: 310-857-0513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162731
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: