Provider Demographics
NPI:1184384638
Name:DALTON, STEPHEN V (RN)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:V
Last Name:DALTON
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 7TH ST RM 200A.06
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1115
Mailing Address - Country:US
Mailing Address - Phone:707-798-0014
Mailing Address - Fax:
Practice Address - Street 1:908 7TH ST RM 200A.06
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1115
Practice Address - Country:US
Practice Address - Phone:707-798-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-25
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA681385163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)