Provider Demographics
NPI:1144418625
Name:SCHROCK, DARYL A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:A
Last Name:SCHROCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11134
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90510-1134
Mailing Address - Country:US
Mailing Address - Phone:310-923-6871
Mailing Address - Fax:310-923-6871
Practice Address - Street 1:2940 W CARSON ST
Practice Address - Street 2:UNIT 235
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6061
Practice Address - Country:US
Practice Address - Phone:310-923-6871
Practice Address - Fax:310-923-6871
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22010103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical