Tammy Lee Brock

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

C4122403 Issued in CA

Practice address

416 Auburn Folsom Rd
Auburn, CA 95603-5515

Phone

(530) 786-7050

NPI assigned

Jul 29, 2019

Last updated

Jul 29, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1548814437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 AUBURN RAVINE RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033606",
            "telephone_number": "530-863-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 AUBURN FOLSOM RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956035515",
            "telephone_number": "530-786-7050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 Auburn Folsom Rd",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "CA",
            "postal_code": "956035515",
            "country_code": "US",
            "telephone_number": "530-786-7050 x53086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "416 Auburn Folsom Rd",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "CA",
            "postal_code": "956035515",
            "country_code": "US",
            "telephone_number": "530-786-7050 x53086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "TAMMY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "C4122403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Auburn, CA
• Providers in Auburn, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; 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.