Provider Demographics
NPI:1730052440
Name:RUSHTON, BETHANY (SLP-CCC)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:RUSHTON
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 BRIMFIELD CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6404
Mailing Address - Country:US
Mailing Address - Phone:916-223-3437
Mailing Address - Fax:
Practice Address - Street 1:303 BRIMFIELD CT
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-6404
Practice Address - Country:US
Practice Address - Phone:916-223-3437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35212235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist