Provider Demographics
NPI:1114742327
Name:LAYTON-RICKETTS, JESSICA (NMT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:LAYTON-RICKETTS
Suffix:
Gender:F
Credentials:NMT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:LAYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NMT
Mailing Address - Street 1:9801 FAIR OAKS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7051
Mailing Address - Country:US
Mailing Address - Phone:916-965-6558
Mailing Address - Fax:
Practice Address - Street 1:9801 FAIR OAKS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7051
Practice Address - Country:US
Practice Address - Phone:916-965-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist