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Individual

ELLERY JAIMES LOCKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
160 W COCHRAN ST, SIMI VALLEY, CA 93065-6215
(805) 864-6641
Mailing address
245 SANTA FE AVE, PISMO BEACH, CA 93449-1948
(224) 789-9696

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21955
CA

Other

Enumeration date
11/18/2022
Last updated
11/18/2022
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