Provider Demographics
NPI:1649614348
Name:PAYTON, RANDI FAY (LM, CPM)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:FAY
Last Name:PAYTON
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8536 STRONG AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-3334
Mailing Address - Country:US
Mailing Address - Phone:916-910-5552
Mailing Address - Fax:916-527-2272
Practice Address - Street 1:8536 STRONG AVE
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-3334
Practice Address - Country:US
Practice Address - Phone:916-910-5552
Practice Address - Fax:916-527-2272
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM368176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife