Healthcare Provider Details

I. General information

NPI: 1295314052
Provider Name (Legal Business Name): RENEE HAUGHTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C ST
SACRAMENTO CA
95816-3300
US

IV. Provider business mailing address

235 BRENTMOOR RD
EAST HARTFORD CT
06118-1711
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6111
  • Fax:
Mailing address:
  • Phone: 860-212-8970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA184579
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA184579
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: