Dean Albert Shrock, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY18597 Issued in CA

Practice address

374 Leandra LN
Eagle Point, OR 97524-6623

Phone

(541) 826-7740

Fax

(541) 826-7740

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194741892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 LEANDRA LN",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975246623",
            "telephone_number": "541-826-7740",
            "fax_number": "541-826-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 LEANDRA LN",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "975246623",
            "telephone_number": "541-826-7740",
            "fax_number": "541-826-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROCK",
        "first_name": "DEAN",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Alethe Rudy, LCSW
• Amanda Salas
• Jennifer D Schnell, LMT#20190
• Brandon Matthew Schultz, D.D.S.
• Theresa L Sexton, RN
• Kimberly A Skomerza, LMT
• Karen Irene Smith, R.PH
• Zane Smith
• Mahabbat Snell, LPC
• Matthew Solomon, PHARMD

• All providers in Eagle Point, OR
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.