Healthcare Provider Details

I. General information

NPI: 1265341754
Provider Name (Legal Business Name): FRANKLIN O ROCKWELL SUDRC 1 #26495
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S MAIN ST
WILLITS CA
95490-3906
US

IV. Provider business mailing address

340 S MAIN ST
WILLITS CA
95490-3906
US

V. Phone/Fax

Practice location:
  • Phone: 707-510-1477
  • Fax:
Mailing address:
  • Phone: 707-510-1477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: