Provider Demographics
NPI:1598488868
Name:BRUTON, TAUTEANA JHANEL (RADT)
Entity Type:Individual
Prefix:
First Name:TAUTEANA
Middle Name:JHANEL
Last Name:BRUTON
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 S MAIN ST APT 302
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-2066
Mailing Address - Country:US
Mailing Address - Phone:213-440-8493
Mailing Address - Fax:
Practice Address - Street 1:5150 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-4134
Practice Address - Country:US
Practice Address - Phone:213-440-8493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)