Provider Demographics
NPI:1043636434
Name:LAYGO, ALLISON (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LAYGO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13638 SPARREN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2175
Mailing Address - Country:US
Mailing Address - Phone:951-347-2422
Mailing Address - Fax:
Practice Address - Street 1:1625 E MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5241
Practice Address - Country:US
Practice Address - Phone:951-347-2422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13733174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist