Provider Demographics
NPI:1043863244
Name:LOCKWOOD, SARAH (MA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:REY
Other - Middle Name:
Other - Last Name:LOCKWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26081 MOCINE AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2923
Mailing Address - Country:US
Mailing Address - Phone:510-881-5921
Mailing Address - Fax:510-881-5925
Practice Address - Street 1:1563 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2543
Practice Address - Country:US
Practice Address - Phone:415-762-3700
Practice Address - Fax:415-554-0159
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112814106H00000X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist