Provider Demographics
NPI:1104038454
Name:LOCKE, HONEY RHONDA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:HONEY
Middle Name:RHONDA
Last Name:LOCKE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 LA MIRAGE CIR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4226
Mailing Address - Country:US
Mailing Address - Phone:949-831-6640
Mailing Address - Fax:949-831-6640
Practice Address - Street 1:3 PURSUIT
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4213
Practice Address - Country:US
Practice Address - Phone:949-707-5555
Practice Address - Fax:949-707-5706
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20384OtherPHYICAL THERAPY LICENSE