Healthcare Provider Details
I. General information
NPI: 1437459849
Provider Name (Legal Business Name): STEPHANIE NICHOLE BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/01/2010
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1860 WALNUT ST
RED BLUFF CA
96080-3611
US
IV. Provider business mailing address
PO BOX 400
RED BLUFF CA
96080-0400
US
V. Phone/Fax
- Phone: 530-527-5631
- Fax:
- Phone: 530-527-8491
- Fax: 530-527-0232
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: