Provider Demographics
NPI:1508166372
Name:LAYNE, CARLETTE ANNE
Entity Type:Individual
Prefix:
First Name:CARLETTE
Middle Name:ANNE
Last Name:LAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARLETTE
Other - Middle Name:ANNE
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5500 MING AVENUE #210
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-834-8341
Mailing Address - Fax:661-834-6095
Practice Address - Street 1:5500 MING AVENUE #210
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-834-8341
Practice Address - Fax:661-834-6095
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT93403106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist