Provider Demographics
NPI:1376958488
Name:CLAYTON, ERICA LESLEY (CRNA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LESLEY
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 VIA MARINA APT 302
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-7230
Mailing Address - Country:US
Mailing Address - Phone:310-963-3490
Mailing Address - Fax:
Practice Address - Street 1:4600 VIA MARINA APT 302
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-7230
Practice Address - Country:US
Practice Address - Phone:310-963-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA737141163W00000X
CA95000197367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse