Healthcare Provider Details

I. General information

NPI: 1518806389
Provider Name (Legal Business Name): ANGELA LOCKWOOD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 GATEWAY PLZ STE C
DIXON CA
95620-9254
US

IV. Provider business mailing address

PO BOX 121
DIXON CA
95620-0121
US

V. Phone/Fax

Practice location:
  • Phone: 707-372-7103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162177
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: