BROCK FORD TRAVIS PH.D.
NPI 1417018987
Psychologist in Lakeport, CA

Active since December 12, 2006
991 PARALLEL DR, LAKEPORT, CA 95453(707) 994-7090(707) 994-7096 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brock Ford Travis Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROCK FORD TRAVIS PH.D. (NPI 1417018987) is an individual psychologist in Lakeport, California, licensed in California (MENTAL HEALTH WAIVER) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1417018987
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameBROCK FORD TRAVISCredential: PH.D.
Location Address991 PARALLEL DRLakeport, CA 95453-5720
Mailing AddressPo Box 1358Cobb, CA 95426-1358 · (707) 928-9600
Fax(707) 994-7096
Sole ProprietorNo
Enumeration DateDecember 12, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1417018987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · MENTAL HEALTH WAIVER
Definition
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 adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
991 PARALLEL DR, Lakeport, CA 95453

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
991 PARALLEL DR
LAKEPORT, CA 95453
Counselor (Mental Health)
991 PARALLEL DR
LAKEPORT, CA 95453
Licensed Psychiatric Technician
991 PARALLEL DR
LAKEPORT, CA 95453
Nurse Practitioner (Psychiatric/Mental Health)
991 PARALLEL DR
LAKEPORT, CA 95453
Counselor (Mental Health)
991 PARALLEL DR
LAKEPORT, CA 95453
Counselor (Mental Health)
991 PARALLEL DR
LAKEPORT, CA 95453
Counselor (Mental Health)
991 PARALLEL DR
LAKEPORT, CA 95453
Marriage & Family Therapist
991 PARALLEL DR
LAKEPORT, CA 95453

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brock Travis's NPI number?

The NPI number for Brock Travis is 1417018987. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Where is Brock Travis located?

Brock Travis practices at 991 Parallel Dr, Lakeport, CA 95453. The listed phone number is (707) 994-7090.

What is Brock Travis's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Brock Travis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.