Healthcare Provider Details

I. General information

NPI: 1831814151
Provider Name (Legal Business Name): STEVEN SEXTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8086 ORANGE AVE
FAIR OAKS CA
95628-5941
US

IV. Provider business mailing address

20271 SW BIRCH ST
NEWPORT BEACH CA
92660-1752
US

V. Phone/Fax

Practice location:
  • Phone: 916-534-7453
  • Fax:
Mailing address:
  • Phone: 949-565-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: