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General NPI Number Information
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NPI Number | 1245953686
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Entity Type | Individual
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Provider Name | AZITA LOCKE NP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 600 S SAN VICENTE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90048-4653
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Country | US
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Telephone | 310-873-3312
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Fax |
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Provider Business Mailing Address
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Address Line | 12855 RUNWAY RD APT 1225
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City | PLAYA VISTA
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State | CA
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Zip | 90094-2667
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Country | US
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Telephone | 805-708-5523
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95022389
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95131887
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License Number State | CA
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