CARYN ANN BROCK (NPI# 1922201458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922201458 |
| Entity Type | Individual |
| Full Name | CARYN ANN BROCK |
| Credential | RAS |
| Practice Address |
127 Grenadine Way Hercules CA 94547-2041 |
| Mailing Address |
1901 Church Ln San Pablo CA 94806-3707 |
| Practice Telephone | 5107997570 |
| Practice Fax Number | 5107991866 |
| Mailing Telephone | 5102363139 |
| Mailing Fax Number | 5102363200 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
127 GRENADINE WAY |
| City | HERCULES |
| State | CA |
| Zip Code | 94547-2041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366563900 | Ujima Family Recovery Services | Substance Abuse Rehabilitation Facility | 127 Grenadine Way, Hercules, CA 94547-2041 | 2007-04-02 |
| 1457598211 | Joyce Penalver | Marriage & Family Therapist | 127 Grenadine Way, Hercules, CA 94547-2041 | 2009-01-15 |
| 1760686992 | Terry K Hatcher | Counselor | 127 Grenadine Way, Hercules, CA 94547-2041 | 2007-06-12 |
| 1124221643 | Phinnillipa Degruy | Counselor | 127 Grenadine Way, Hercules, CA 94547-2041 | 2007-06-11 |
| 1619171147 | Dawn Yvette Murray | Counselor | 127 Grenadine Way, Hercules, CA 94547-2041 | 2007-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768286 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4080 San Pablo Ave, Hercules, CA 94547 | 2020-01-06 |
| 1407415144 | Julita Chinyere Agwumezie | Pharmacist | 1590 Sycamore Avenue, Hercules, CA 94547 | 2019-06-06 |
| 1730545666 | Evelyn Gomez | Behavioral Analyst | 115 Starling Way, Hercules, CA 94547 | 2016-01-07 |
| 1730572264 | Laith Anwar Yacoub | Pharmacist | 530 Silver Maple Dr., Hercules, CA 94547 | 2015-03-09 |
| 1396171526 | Yeun Joo Kim | Dentist | 9 Arete Court, Hercules, CA 94547 | 2013-09-19 |
| 1568751527 | Sophie Chen | Dentist | 500 Alfred Nobel Drive, Suite 130, Hercules, CA 94547 | 2011-03-30 |
| 1962654517 | Jason M. Hataye | Student in an Organized Health Care Education/Training Program | 572 Turquoise Drive, Hercules, CA 94547 | 2008-10-15 |
| 1649454802 | Lovely C. Manlapaz | Dentist | 844 Willow Avenue, Suite - A6, Hercules, CA 94547 | 2007-12-24 |
| 1386823805 | Vincent T Chen | Dentist | 500 Alfred Nobel Dr., Ste. 280, Hercules, CA 94547 | 2007-11-01 |
| 1902950132 | Leonard Alexander Newman | Ophthalmology | 500 Alfred Noble Dr, Ste 225, Hercules, CA 94547 | 2007-01-23 |
| Find all providers in zip 94547 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1538760871 | Ky Washington | Counselor | 1625 Sweetwater Rd # C1, National City, CA 91950-7647 | 2020-11-03 |
| 1164022976 | Denise Renee Hands | Counselor | 4604 E Terrace Ave, Fresno, CA 93703-2079 | 2020-10-30 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1548869266 | Yama Totakhail | Counselor | 915 Bryant St # 94103, San Francisco, CA 94103-4514 | 2020-10-23 |
| 1053910901 | Eduardo Alberto Perez | Counselor | 8829 Dewsbury Ave, San Diego, CA 92126-2428 | 2020-10-21 |
| 1285233155 | Alaric Fairchild | Counselor | 1400 N Johnson Ave Ste 1011400n, El Cajon, CA 92020-1650 | 2020-10-21 |
| 1487253571 | Roxanne Rene Coito | Counselor | 1919 Apple St # D, Oceanside, CA 92054-4425 | 2020-10-20 |
| 1255939732 | Diana Palencia | Counselor | 44459 10th St W, Lancaster, CA 93534-3324 | 2020-10-15 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.