Caryn Ann Brock, RAS
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Hercules, CA
NPI 1922201458 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922201458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 127 Grenadine Way
Hercules, CA 94547-2041 - Phone
- (510) 799-7570
- Fax
- (510) 799-1866
- NPI assigned
- Jun 11, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ujima Family Recovery Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
127 Grenadine Way
Hercules, CA 94547-2041
Mailing address
1901 Church LN
San Pablo, CA 94806-3707
Phone (510) 236-3139
Other providers in Hercules, CA
- Benece Juanda Booker
- BR Pucan II Professional Dental Corporation
- Darren Bracey
- Ayante Braggs
- Boris Yakov Brand
- Jayland Rudolph Brooks
- Doris Lorraine Brown
- Emma May Bumgarner
- Vera Renee Burch
- Skye Cristin Cabuloy
All providers in Hercules, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.