Provider Demographics
NPI:1326396540
Name:LAYTON, DARLENE MAE (BS)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:MAE
Last Name:LAYTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 DAISY AVE
Mailing Address - Street 2:APT D
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-1830
Mailing Address - Country:US
Mailing Address - Phone:512-550-7961
Mailing Address - Fax:
Practice Address - Street 1:3111 CAMINO DEL RIO N
Practice Address - Street 2:SUITE 467
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-5720
Practice Address - Country:US
Practice Address - Phone:619-528-2363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor