Provider Demographics
NPI:1073798195
Name:LAYNE, CAROL JEAN (MS)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:LAYNE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 YGNACIO VALLEY RD
Mailing Address - Street 2:C-202
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3391
Mailing Address - Country:US
Mailing Address - Phone:925-945-1474
Mailing Address - Fax:925-945-1483
Practice Address - Street 1:2021 YGNACIO VALLEY RD
Practice Address - Street 2:C-202
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3391
Practice Address - Country:US
Practice Address - Phone:925-945-1474
Practice Address - Fax:925-945-1483
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist