Provider Demographics
NPI:1568584027
Name:LOCSIN, MARIA SOCORRO (L AC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SOCORRO
Last Name:LOCSIN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:LOCSIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L AC
Mailing Address - Street 1:2211 4TH ST
Mailing Address - Street 2:APT. # 202
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-2357
Mailing Address - Country:US
Mailing Address - Phone:310-396-4195
Mailing Address - Fax:310-473-9767
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:310-396-4195
Practice Address - Fax:310-473-9767
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9354133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9354OtherACUPUNCTURE