Provider Demographics
NPI:1487785671
Name:LOCKWOOD, CATHERINE GAIL (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:GAIL
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 MONTANA AVE., # 269
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-1652
Mailing Address - Country:US
Mailing Address - Phone:310-488-5292
Mailing Address - Fax:310-828-0870
Practice Address - Street 1:179 S BARRINGTON PL STE B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-3305
Practice Address - Country:US
Practice Address - Phone:310-488-5292
Practice Address - Fax:310-828-0870
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38789106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist