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General NPI Number Information
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NPI Number | 1568403954
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Entity Type | Individual
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Provider Name | MOIRA S. LOCKE MD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 144 SOUTH 'L' ST
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City | DINUBA
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State | CA
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Zip | 93618
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Country | US
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Telephone | 559-591-6680
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Fax | 559-591-4606
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Provider Business Mailing Address
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Address Line | PO BOX 2634
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City | PALOS VERDES PENINSULA
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State | CA
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Zip | 90274-8634
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Country | US
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Telephone | 310-985-4422
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A101543
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD-12646
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD-12646
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License Number State | HI
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