Provider Demographics
NPI:1255307724
Name:LAYA, JOSEPH WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:LAYA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 HATRNELL AVE.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0748
Mailing Address - Country:US
Mailing Address - Phone:530-223-2325
Mailing Address - Fax:530-223-2252
Practice Address - Street 1:1751 HATRNELL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0748
Practice Address - Country:US
Practice Address - Phone:530-223-2325
Practice Address - Fax:530-223-2252
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 7982 TPA152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0079821Medicare PIN
CAT79399Medicare UPIN