Provider Demographics
NPI:1194588947
Name:LOCKWOOD, KIMBERLY DIANNE (CLD)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DIANNE
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 E ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-5320
Mailing Address - Country:US
Mailing Address - Phone:707-809-5859
Mailing Address - Fax:
Practice Address - Street 1:3117 E ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-5320
Practice Address - Country:US
Practice Address - Phone:707-809-5859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula