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General NPI Number Information
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NPI Number | 1407457377
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Entity Type | Individual
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Provider Name | MARIAN LOCKE
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 3901 W ADAMS BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90018-1756
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Country | US
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Telephone | 323-605-6470
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Fax |
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Provider Business Mailing Address
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Address Line | 13001 RAMONA BLVD STE E
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City | IRWINDALE
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State | CA
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Zip | 91706-3752
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Country | US
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Telephone | 626-472-6000
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | CA
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