Individual provider · Type 1 NPI

Brock Ford Travis, PhD

Psychologist · Lakeport, CA

NPI number 1417018987 Active

Practice location

991 Parallel Dr
Lakeport, CA 95453-5720

Call (707) 994-7090 Map

Fax (707) 994-7096

Mailing address

PO Box 1358
Cobb, CA 95426-1358

Specialties and licenses

TaxonomyCodeLicense
Psychologist Primary 103T00000XMENTAL HEALTH WAIVER (CA)

Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…

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About NPI 1417018987

Brock Ford Travis, PhD's National Provider Identifier is 1417018987, issued on Dec 12, 2006. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in Lakeport, CA. The record was last updated on Jul 8, 2007.