Provider Demographics
NPI:1740887314
Name:LAYTON, BRETT MICHAEL
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:MICHAEL
Last Name:LAYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5193 CHAPS WAY
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-8995
Mailing Address - Country:US
Mailing Address - Phone:909-528-4599
Mailing Address - Fax:
Practice Address - Street 1:175 E NUEVO RD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-2910
Practice Address - Country:US
Practice Address - Phone:951-657-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA145478106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist