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NPI Code Detail

MEDICARE: BREANNA LOCKE BCBA

MEDICARE: BREANNA LOCKE BCBA
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
1103K00000XBehavior Analyst1-14-17469CA

General Provider Information

NPI Number : 1861887416
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA LOCKE BCBA
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 334 VIA VERA CRUZ STE 107
Second Line :
City : SAN MARCOS
State : CA
Zip : 92078-2637
Country : US
Telephone Number : 760-304-5010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2015
Last Update Date : 07/21/2022

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Directions to “ BREANNA LOCKE BCBA” Practice Location

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