Travis, Brock Ford

Travis, Brock Ford is an individual health care provider with primary practice located at 991 Parallel Dr , Lakeport CA 95453-5720. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Travis, Brock Ford can be contacted via phone (707) 994-7090.

Contact Information

Primary practice address
991 Parallel Dr Lakeport CA 95453-5720
Phone: (707) 994-7090
Fax: (707) 994-7096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X MENTAL HEALTH WAIVER California

Profile Details

NPI number 1417018987
LBN Legal business name Travis, Brock Ford
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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