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NPI Code Detail

MEDICARE: MRS. AMANDA L LOCKIE

MEDICARE: MRS. AMANDA L LOCKIE
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
1225400000XRehabilitation Practitioner
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1841562048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA L LOCKIE
Provider Business Mailing Address
First Line : PO BOX 175
Second Line :
City : LITCHFIELD
State : CA
Zip : 96117-0175
Country : US
Telephone Number : 530-310-4882
Fax Number :
Provider Business Practice Location Address
First Line : 105 E SYDNOR AVE STE 100
Second Line :
City : RIDGECREST
State : CA
Zip : 93555-5546
Country : US
Telephone Number : 760-446-6404
Fax Number : 760-446-6415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2012
Last Update Date : 05/18/2021

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Directions to “ MRS. AMANDA L LOCKIE ” Practice Location

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