Healthcare Provider Details

I. General information

NPI: 1760220883
Provider Name (Legal Business Name): BRIAN CURTIS HOCKETT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17862 17TH ST STE 107
TUSTIN CA
92780-2170
US

IV. Provider business mailing address

17862 17TH ST STE 107
TUSTIN CA
92780-2170
US

V. Phone/Fax

Practice location:
  • Phone: 714-661-5390
  • Fax: 714-661-5449
Mailing address:
  • Phone: 714-661-5390
  • Fax: 714-661-5449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: