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Jack Douglas Lockhart
Peer Specialist in San Diego, California
NPI 1518481993

Jack Douglas Lockhart is a Peer Specialist based in San Diego, CA. Jack Douglas Lockhart practices in San Diego, CA. The NPI Number for Jack Douglas Lockhart is 1518481993 and holds a License No. MPSS-CWYSEG (California).

The current practice location address for Jack Douglas Lockhart is 10717 Camino Ruiz Ste 207, San Diego, CA and can be reached out via phone at 858-695-2211 and via fax at 858-695-3521.

Location: 10717 Camino Ruiz Ste 207, San Diego, CA, 92126-2364
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518481993
Provider Name
Jack Douglas Lockhart
Credential
Provider Entity Type
Individual
Gender
Male
Address
10717 Camino Ruiz Ste 207, San Diego, CA, 92126-2364
Phone Number
858-695-2211
Fax Number
858-695-3521
Provider Enumeration Date
07/27/2017
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
10717 Camino Ruiz Ste 207
City
San Diego
State
California
Zip
92126-2364
Phone Number
858-695-2211
Fax Number
858-695-3521
person
Provider Business Mailing Address Details
Address
10717 Camino Ruiz Ste 207
City
San Diego
State
California
Zip
92126-2364
Phone Number
858-695-2211
Fax Number
858-695-3521
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
MPSS-CWYSEG (California)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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