Provider Demographics
NPI:1386719383
Name:LAYFIELD, SUSAN (PT,DPT, MS,OCS)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:LAYFIELD
Suffix:
Gender:F
Credentials:PT,DPT, MS,OCS
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:PAULSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16101 VENTURA BLVD
Mailing Address - Street 2:STE 336
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2500
Mailing Address - Country:US
Mailing Address - Phone:818-905-1331
Mailing Address - Fax:818-905-8836
Practice Address - Street 1:16101 VENTURA BLVD STE 336
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2516
Practice Address - Country:US
Practice Address - Phone:818-905-1331
Practice Address - Fax:818-905-8836
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT7633AMedicare UPIN