Provider Demographics
NPI:1235948555
Name:LOCKLIN, KAYLEEN MICHELLE (LVN LICENSE)
Entity type:Individual
Prefix:
First Name:KAYLEEN
Middle Name:MICHELLE
Last Name:LOCKLIN
Suffix:
Gender:F
Credentials:LVN LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 DALTON CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4425
Mailing Address - Country:US
Mailing Address - Phone:951-209-9963
Mailing Address - Fax:
Practice Address - Street 1:30 DALTON CT
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4425
Practice Address - Country:US
Practice Address - Phone:951-209-9963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN741263164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse