Bethany Kristin Clark, FNP
NPI 1639953433ActiveIndividual· Nurse Practitioner, Family· Fullerton, CA
Nurse Practitioner, Family (FNP) with Providence Medical Foundation and 1 other group, practicing in Fullerton, California. Enrolled in Medicare as practitioner - nurse practitioner. Millicent US Inc was the largest of 3 companies reporting payments in 2025, $462.33 in all, mostly food and beverage. Lists Providence St. Jude Medical Center as a hospital affiliation.
Overview
| NPI | 1639953433 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | FNP |
| Sole proprietor | Yes |
| NPI issued | Aug 22, 2023 |
| Last updated in NPPES | Jun 17, 2026 |
| Certified by provider | Jun 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 95026372 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (CA) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical groups
- Providence Medical FoundationVictorville, CA · 1,466 clinicians
- OB-GYN Place A Medical CorporationGlendale, CA · 2 clinicians
Hospital affiliation
- Providence St. Jude Medical CenterFullerton, CA
Industry payments (Open Payments)
- 2025$462.33 · 27 payments from 3 companies
- 2024$227.68 · 13 payments from 6 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Millicent US Inc | $177.26 | 8 |
| Mayne Pharma Commercial LLC | $160.94 | 14 |
| Sumitomo Pharma America, Inc. | $124.13 | 5 |
What the 2025 payments were for
- Food and Beverage$462.33 · 27 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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