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NPI 1295511095

NPI 1295511095 : BILLIE DANIELLE LOCKETT : ESCONDIDO, CA

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General NPI Number Information
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    NPI Number           |    1295511095
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    Entity Type          |    Individual 
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    Provider Name        |    BILLIE DANIELLE LOCKETT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/06/2023
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    Last Update Date     |    06/19/2025
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Provider Practice Location Address
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    Address Line         |    460 N ELM ST 
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    City                 |    ESCONDIDO
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    State                |    CA
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    Zip                  |    92025-3002
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    Country              |    US
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    Telephone            |    833-867-4642
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    460 N ELM ST 
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    City                 |    ESCONDIDO
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    State                |    CA
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    Zip                  |    92025-3002
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    Country              |    US
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    Telephone            |    
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA65830
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    License Number State |    CA
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