Provider Demographics
NPI:1275063752
Name:LOCKE, JAMES SCARTH III (MSOT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SCARTH
Last Name:LOCKE
Suffix:III
Gender:M
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 41ST ST APT D
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2534
Mailing Address - Country:US
Mailing Address - Phone:510-717-5789
Mailing Address - Fax:
Practice Address - Street 1:110 41ST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5250
Practice Address - Country:US
Practice Address - Phone:510-597-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT12642225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist