What is Tyquan Broddock's NPI number?

Tyquan Broddock's National Provider Identifier (NPI) is 1962162693, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Tyquan Broddock's specialty?

Tyquan Broddock is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).

Where is Tyquan Broddock located?

Tyquan Broddock's practice location on file with NPPES is 15490 Civic Dr, Victorville, CA 92392-2924.

What is Tyquan Broddock's phone number?

The practice phone number listed in the NPPES registry for Tyquan Broddock is (442) 327-9172.

Is Tyquan Broddock's NPI active?

Yes — Tyquan Broddock's NPI (1962162693) is active in the NPPES registry as of the last update on 2021-12-21.

IndividualActive

Tyquan Broddock

NPI 1962162693 · Behavior Technician · Victorville, CA

Tyquan Broddock is a Behavior Technician provider in Victorville, CA (NPI 1962162693).

Provider details

NPI number: 1962162693
Entity type: Individual
Primary specialty: Behavior TechnicianBehavioral Health & Social Service Providers
Sex: Male
Sole proprietor: No

Specialties & taxonomies

Behavior TechnicianPrimary106S00000X
Behavioral Health & Social Service Providers

Profile Score

Established profile(55/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
4 yrs in NPPES registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

15490 Civic Dr

Victorville, CA 92392-2924

Phone: (442) 327-9172

Approximate (ZIP-level) locationGet directions

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Mailing address