Provider Demographics
NPI:1013145085
Name:LAYMAN, JENNIFER CAROLYNN (MFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CAROLYNN
Last Name:LAYMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S KRAEMER BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-6100
Mailing Address - Country:US
Mailing Address - Phone:714-223-7233
Mailing Address - Fax:
Practice Address - Street 1:101 S KRAEMER BLVD STE 130
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6100
Practice Address - Country:US
Practice Address - Phone:714-223-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44398106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist