Michelle Brock, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95100284 Issued in CA

Practice address

4508 Atlantic Ave Ste a-443
Long Beach, CA 90807-1520

Phone

(304) 550-4962

NPI assigned

Aug 26, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1235742446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23655 AQUACATE RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834131",
            "telephone_number": "304-550-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 ATLANTIC AVE STE A-443",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908071520",
            "telephone_number": "304-550-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95100284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
            "identifier": "95100284",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jolae (Jo) Brocato, LCSW
• Sarah Anita Brock Chavez, LCSW
• Brock Lorenz Dental Corporation
• Catherine M. Brock, MA, LMHC, LPCC
• Jaishawn Lenna Brock
• Zoe Brockway
• Broderick Chiropractic Corporation
• Lindsay Margret Weber Broderick, D.C.
• Merrick Adam Brodsky, MD
• Hayden Brogdon

• Registered Nurse in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.