Provider Demographics
NPI:1003663766
Name:LOCKARD, LORI SUZAN (ACSW)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:SUZAN
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:SUZAN
Other - Last Name:BUDNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACSW
Mailing Address - Street 1:702 WORKMAN ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-6800
Mailing Address - Country:US
Mailing Address - Phone:661-549-1555
Mailing Address - Fax:
Practice Address - Street 1:3433 W SHAW AVE STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3229
Practice Address - Country:US
Practice Address - Phone:559-558-4051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1042223104100000X
CA1042231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker