Healthcare Provider Details

I. General information

NPI: 1124741236
Provider Name (Legal Business Name): AVA KATHRYN LOKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 S LINCOLN ST STE 10
LITTLETON CO
80122-2725
US

IV. Provider business mailing address

10884 W COCO PL
LITTLETON CO
80127-4112
US

V. Phone/Fax

Practice location:
  • Phone: 720-319-7614
  • Fax:
Mailing address:
  • Phone: 172-031-7555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-230636
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: