Provider Demographics
NPI:1689874281
Name:LAYTON, JENIFER LYNN (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:LYNN
Last Name:LAYTON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:LYNN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11645 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5024
Mailing Address - Country:US
Mailing Address - Phone:530-273-4431
Mailing Address - Fax:
Practice Address - Street 1:11645 RIDGE RD
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5024
Practice Address - Country:US
Practice Address - Phone:530-273-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 51971106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist