Healthcare Provider Details

I. General information

NPI: 1811434236
Provider Name (Legal Business Name): LAYNE E BAKER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41689 ENTERPRISE CIR N STE 114
TEMECULA CA
92590-5630
US

IV. Provider business mailing address

PO BOX 890972
TEMECULA CA
92589-0972
US

V. Phone/Fax

Practice location:
  • Phone: 323-806-1429
  • Fax:
Mailing address:
  • Phone: 323-806-1429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number96754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: