MEDICARE: WILL STRATTON RBT

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	RBT-22-236192	CA

General Provider Information

NPI Number	:	1346927043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILL STRATTON RBT

Provider Business Mailing Address
First Line	:	1150 S KING RD STE 40
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-2140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 S KING RD STE 40
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-2140
Country	:	US
Telephone Number	:	650-995-4999
Fax Number	:

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

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	07/03/2023

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Directions to “ WILL STRATTON RBT” Practice Location

Language	Start Address	Practice Location

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