Brock Ford Travis in Lakeport - Psychologist
Brock Ford Travis - NPI 1417018987
Brock Ford Travis is a Psychologist in Lakeport, California. Brock Ford Travis practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Brock Ford Travis is 1417018987. The last update date is 2007-07-08.
Brock Ford Travis's current location address is 991 Parallel Dr, Lakeport, California. You can contact this provider via phone number 7079947090 and fax number 7079947096. The mailing address for Brock Ford Travis is 991 Parallel Dr, Lakeport, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brock Ford Travis |
|---|---|
| Address | 991 Parallel Dr, Lakeport, California |
| Phone Number | 7079947090 |
| Fax Number | 7079947096 |
| Sole Proprietor | N |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1417018987 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 991 Parallel Dr |
|---|---|
| City | Lakeport |
| State | California (CA) |
| Post Code | 954535720 |
| Phone Number | 7079947090 |
| Fax Number | 7079947096 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | MENTAL HEALT |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the unique 10-digit identifier code issued to Brock Ford Travis by the Centers for Medicare & Medicaid Services?
The Brock Ford Travis has been assigned the NPI (National Provider Identifier) 1417018987 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Brock Ford Travis is physically located?
The Brock Ford Travis is situated at the following address: 991 Parallel Dr, Lakeport, CA 954535720.
What is Brock Ford Travis's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Brock Ford Travis's specialized field of practice is Psychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103T00000X.
On what date was the 1417018987 assigned to Brock Ford Travis?
The Brock Ford Travis was issued its 1417018987 on 2006-12-12, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Brock Ford Travis most recently updated or refreshed?
The details pertaining to the Brock Ford Travis, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
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