Healthcare Provider Details

I. General information

NPI: 1770438517
Provider Name (Legal Business Name): AMBER VERONICA LOCKE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3195 HEATHER LN
ALPINE CA
91901-1568
US

IV. Provider business mailing address

3195 HEATHER LN
ALPINE CA
91901-1568
US

V. Phone/Fax

Practice location:
  • Phone: 619-212-9553
  • Fax:
Mailing address:
  • Phone: 619-212-9553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95036304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: