Healthcare Provider Details

I. General information

NPI: 1518879303
Provider Name (Legal Business Name): STACEY R SINGLETON CLD, CPD, CLSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2856 E HIDEOUT DR
EAGLE MOUNTAIN UT
84005-5401
US

IV. Provider business mailing address

2856 E HIDEOUT DR
EAGLE MOUNTAIN UT
84005-5401
US

V. Phone/Fax

Practice location:
  • Phone: 949-278-3589
  • Fax:
Mailing address:
  • Phone: 949-278-3589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: