Jacqueline Suresh Layton, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1085359 Issued in TX

Practice address

17324 Glencoe Ave
Lakeville, MN 55044-7429

Phone

(612) 718-0620

NPI assigned

Jun 30, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Jacqueline Suresh Caston Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1699392266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17324 GLENCOE AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447429",
            "telephone_number": "612-718-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17324 GLENCOE AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447429",
            "telephone_number": "612-718-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYTON",
        "first_name": "JACQUELINE",
        "middle_name": "SURESH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "1085359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "CASTON",
            "middle_name": "SURESH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie Jo Larsen, FNP
• Emily Larson
• Emily Larson
• Madeline Lorraine Larson
• Gerard David Lasalle, MS LP
• Ashley Le
• Sharon Le, PHARM D
• Kailey Jo Leach, MS, CCC-SLP
• Lead Care LLC
• Cassie Marie Lebrun

• Clinical Psychologist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.