Provider Demographics
NPI:1205266830
Name:LOCKSHIN, JULIE (RRW)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:LOCKSHIN
Suffix:
Gender:F
Credentials:RRW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 SILVER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-1734
Mailing Address - Country:US
Mailing Address - Phone:707-712-7733
Mailing Address - Fax:
Practice Address - Street 1:5420 POWER INN ROAD SUITE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820
Practice Address - Country:US
Practice Address - Phone:916-388-9418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)