Provider Demographics
NPI:1891554879
Name:HOLLINS-LOCKLEY, TAMIKA
Entity Type:Individual
Prefix:MRS
First Name:TAMIKA
Middle Name:
Last Name:HOLLINS-LOCKLEY
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 1:11401 VANDERGRIFT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7127
Mailing Address - Country:US
Mailing Address - Phone:213-458-2360
Mailing Address - Fax:
Practice Address - Street 1:11401 VANDERGRIFT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7127
Practice Address - Country:US
Practice Address - Phone:213-458-2360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty