Healthcare Provider Details

I. General information

NPI: 1811962384
Provider Name (Legal Business Name): ABIMBOLA OLUFEMI LAYENI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HESPERIA RD
VICTORVILLE CA
92395-7720
US

IV. Provider business mailing address

236 ZACHARY WALK
MURPHY TX
75094-3790
US

V. Phone/Fax

Practice location:
  • Phone: 760-995-8300
  • Fax:
Mailing address:
  • Phone: 972-768-2880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberCDR.0002720
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC198781
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberL0369
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: