Provider Demographics
NPI:1215576004
Name:LOSKA, AMY GEORGETTE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GEORGETTE
Last Name:LOSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS REY
Mailing Address - State:CA
Mailing Address - Zip Code:92068-0104
Mailing Address - Country:US
Mailing Address - Phone:714-992-1677
Mailing Address - Fax:
Practice Address - Street 1:3355 MISSION AVE STE 238
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1303
Practice Address - Country:US
Practice Address - Phone:760-722-0672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty