MEDICARE: BETHANY CLAYTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	BACB1324657	CA

General Provider Information

NPI Number	:	1245173822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY CLAYTON

Provider Business Mailing Address
First Line	:	8549 WILSHIRE BLVD # 349
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3104
Country	:	US
Telephone Number	:	424-302-1007
Fax Number	:

Provider Business Practice Location Address
First Line	:	10547 SANTA MONICA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-4907
Country	:	US
Telephone Number	:	310-475-9004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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