Healthcare Provider Details

I. General information

NPI: 1134120207
Provider Name (Legal Business Name): CHRISTY WEEKS LOCKE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N CALIFORNIA ST ST. JOSEPH'S MEDICAL CENTER - PHARMACY DEPT
STOCKTON CA
95204-6019
US

IV. Provider business mailing address

PO BOX 811
LOCKEFORD CA
95237-0811
US

V. Phone/Fax

Practice location:
  • Phone: 209-461-5100
  • Fax: 209-944-8350
Mailing address:
  • Phone: 209-467-6518
  • Fax: 209-944-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number40104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: