Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1134552425 Deactivated / Inactive NPI Male Practitioner

Dr. Randolph F Brock , PsyD

Psychologist - Psychoanalysis • Soquel, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Randolph Brock has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 09, 2013
NPI Deactivation Date October 30, 2024
Total Practice Duration ~11 Years of Practice (2013 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Randolph Brock, PsyD was a registered Psychologist - Psychoanalysis practicing in Soquel, CA. Throughout an active medical career spanning 11 years, Dr. Brock provided care at the practice location at 3121 PARK AVE until profile deactivation on 2024-10-30.

Practice Location & Contact Primary Location

Practice Address

3121 Park Ave
Suite I

Soquel, CA 950732920

Telephone 9546478077
Associated Practice Facility / Clinic
🏢 Qualium Corp Facility NPI 1710237920

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Psychoanalysis in Soquel, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 39.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Soquel, CA (58 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Psychoanalysis Primary Specialty

NUCC Taxonomy Code: 103TP0814X

State License CA PSY25407

A psychologist whose specialty is distinguished from other specialties by its body of knowledge and its intensive treatment approaches. It aims at structural changes and modifications of a person's personality. Psychoanalysis promotes awareness of unconscious, maladaptive and habitually recurrent patterns of emotion and behavior, allowing previously unconscious aspects of the self to become integrated and promoting optimal functioning, healing and creative expression.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Dr. Peter Thibodeau , DC

Chiropractor - Neurology

NPI 1114952629

Doctor of Chiropractic

Anne Howard , MPT

Physical Therapist

NPI 1194708040

Master of Physical Therapy

Aneita Radov , MA, LMFT, CEAP

Marriage & Family Therapist

NPI 1235163411

Master of Arts, Licensed Marriage and Family Therapist, CEAP

Lisa Lin , LAC

Acupuncturist

NPI 1548395692

Licensed Acupuncturist

Debra Houston , LMFT

Marriage & Family Therapist

NPI 1629494521

Licensed Marriage and Family Therapist

NPI 1679937924

BAMSMD(AYUINDIA)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 30, 2024

Record deactivated on October 30, 2024

NPI Profile Active August 09, 2013

NPI status registered as active in NPPES database

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Updated Practice Location August 09, 2013

Registered at 3121 PARK AVE, SUITE I, SOQUEL, CA 950732920 (Tel: 9546478077)

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Updated Business Mailing Address August 09, 2013

Registered at 3230 CRYSTAL HEIGHTS DR, SOQUEL, CA 950732517 (Tel: 9546478077)

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Provider Name / Credentials Updated August 09, 2013

Recorded as RANDOLPH BROCK, PSY.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 09, 2013

Psychologist (License #PSY25407 in CA)

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Initial NPI Registration & Enumeration August 09, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134552425
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 09, 2013
Last Update: August 09, 2013
Deactivation Date: October 30, 2024

Mailing Address

3230 Crystal Heights Dr

Soquel, CA 950732517

Phone: 9546478077

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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