MEDICARE: LEIANDREA LAYUS AMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	129720	CA

General Provider Information

NPI Number	:	1952006827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIANDREA LAYUS AMFT

Provider Business Mailing Address
First Line	:	203 FLAMINGO RD.
Second Line	:	P.O. BOX #248
City	:	MILL VALLEY
State	:	CA
Zip	:	94941
Country	:	US
Telephone Number	:	408-489-1898
Fax Number	:

Provider Business Practice Location Address
First Line	:	6536 TELEGRAPH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94609-1192
Country	:	US
Telephone Number	:	510-496-6002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2023
Last Update Date	:	03/31/2023

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