MEDICARE: JAMIE LOCKWICH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	744016	CA

General Provider Information

NPI Number	:	1447621248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE LOCKWICH

Provider Business Mailing Address
First Line	:	40600 ALABAMA HILLS DR
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92203-3871
Country	:	US
Telephone Number	:	760-296-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	40600 ALABAMA HILLS DR
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92203-3871
Country	:	US
Telephone Number	:	760-296-3132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/19/2015

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Directions to “ JAMIE LOCKWICH ” Practice Location

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