Individual
STACY BRUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
711 G ST, SACRAMENTO, CA 95814-1212
(999) 999-9999
Mailing address
1625 E 8TH ST APT 32, DAVIS, CA 95616-2445
(515) 339-2464
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
119649
IA
101YP2500X
Professional Counselor
Primary
17899
CA
101YP2500X
Professional Counselor
Primary
22080
CA
Other
Enumeration date
06/02/2023
Last updated
05/07/2026
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