black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

EMBROKER INS SERVICES LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN258130
Status:
Active
First Licensure:
10/07/2015
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
309 LAKE ST
SAN FRANCISCO, CA 94118-1320
Mailing:
5214F DIAMOND HEIGHTS BLVD UNIT 1261 PMB 1261
SAN FRANCISCO, CA 94131-2175
Phone:
+1 (844) 436-2765
Fax:
+1 (415) 520-5379
Email:
compliance@embroker.com

History
License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 10/07/2015 04/01/2027

Employer
Name Issue Date License Number Expiration Date Cancel Date
ACE AMERICAN INSURANCE COMPANY
 02/08/2017 PCF640
ACE FIRE UNDERWRITERS INSURANCE COMPANY
 02/08/2017 PCF43
ACE PROPERTY & CASUALTY INSURANCE COMPANY
 02/08/2017 PCF44
ALLMERICA FINANCIAL ALLIANCE INSURANCE COMPANY
 07/11/2016 PCF75617
ALLMERICA FINANCIAL BENEFIT INSURANCE COMPANY
 07/11/2016 PCF145893
AMTRUST INSURANCE COMPANY
 09/20/2022 PCF260762
ARCH INSURANCE COMPANY
 12/28/2017 PCF62719
BANKERS STANDARD INSURANCE COMPANY
 02/01/2018 PCF152165
THE CHARTER OAK FIRE INSURANCE COMPANY
 05/10/2016 PCF403 07/11/2017
CHUBB INDEMNITY INSURANCE COMPANY
 02/01/2018 PCF591
CHUBB NATIONAL INSURANCE COMPANY
 02/08/2017 PCF80404
CITIZENS INSURANCE COMPANY OF AMERICA
 07/11/2016 PCF937
CONTINENTAL CASUALTY COMPANY
 10/15/2018 PCF420
EVEREST NATIONAL INSURANCE COMPANY
 09/26/2019 PCF99574
EXECUTIVE RISK INDEMNITY INC.
 02/01/2018 PCF42522
FARMINGTON CASUALTY COMPANY
 05/10/2016 PCF995 07/11/2017
FEDERAL INSURANCE COMPANY
 02/08/2017 PCF439
GREAT AMERICAN ALLIANCE INSURANCE COMPANY
 10/30/2019 PCF46804
GREAT AMERICAN ASSURANCE COMPANY
 10/30/2019 PCF702
GREAT AMERICAN INSURANCE COMPANY
 10/30/2019 PCF764
GREAT AMERICAN SPIRIT INSURANCE COMPANY
 10/30/2019 PCF46805
GREAT NORTHERN INSURANCE COMPANY
 02/08/2017 PCF455
THE HANOVER AMERICAN INSURANCE COMPANY
 07/11/2016 PCF197298
THE HANOVER INSURANCE COMPANY
 07/11/2016 PCF712
HARTFORD FIRE INSURANCE COMPANY
 04/16/2018 PCF464 06/03/2021
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
 04/11/2017 LHF193
HARTFORD UNDERWRITERS INSURANCE COMPANY
 01/29/2024 PCF992
MASSACHUSETTS BAY INSURANCE COMPANY
 07/11/2016 PCF505
MIDVALE INDEMNITY COMPANY
 12/18/2017 PCF79410
PACIFIC EMPLOYERS INSURANCE COMPANY
 02/01/2018 PCF546
PACIFIC INDEMNITY COMPANY
 02/08/2017 PCF547
THE PHOENIX INSURANCE COMPANY
 05/10/2016 PCF557 07/11/2017
PROPERTY & CASUALTY INSURANCE COMPANY OF HARTFORD
 07/03/2024 PCF47445
SECURITY NATIONAL INSURANCE COMPANY
 08/18/2017 PCF189490
SEQUOIA INSURANCE COMPANY
 04/23/2020 PCF128467
ST. PAUL FIRE AND MARINE INSURANCE COMPANY
 12/07/2016 PCF575 07/18/2018
ST. PAUL GUARDIAN INSURANCE COMPANY
 12/07/2016 PCF701 07/18/2018
ST. PAUL MERCURY INSURANCE COMPANY
 12/07/2016 PCF576 07/18/2018
THE STANDARD FIRE INSURANCE COMPANY
 05/10/2016 PCF584 07/11/2017
TECHNOLOGY INSURANCE COMPANY INC
 08/18/2017 PCF136874
TRAVELERS CASUALTY AND SURETY COMPANY
 05/10/2016 PCF348 07/11/2017
TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA
 05/10/2016 PCF935 07/11/2017
TRAVELERS COMMERCIAL CASUALTY COMPANY
 05/10/2016 PCF83507 07/11/2017
THE TRAVELERS INDEMNITY COMPANY OF AMERICA
 05/10/2016 PCF585 07/11/2017
THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT
 05/10/2016 PCF435 07/11/2017
THE TRAVELERS INDEMNITY COMPANY
 05/10/2016 PCF602 07/11/2017
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
 05/10/2016 PCF711 07/11/2017
TWIN CITY FIRE INSURANCE COMPANY
 11/27/2018 PCF963
UNITEDHEALTHCARE INSURANCE COMPANY
 10/20/2017 LHF700
UNITEDHEALTHCARE OF NEW ENGLAND, INC.
 11/01/2021 HMF393375
VALLEY FORGE INSURANCE COMPANY
 10/07/2019 PCF612
VIGILANT INSURANCE COMPANY
 02/08/2017 PCF613
WESCO INSURANCE COMPANY
 08/18/2017 PCF49735
WESTCHESTER FIRE INSURANCE COMPANY
 02/08/2017 PCF177973

Affiliated Agent
Name Issue Date License Number Expiration Date Cancel Date
DAN LEONARD CAMUSO
 12/06/2019 PRN345546
TYLER MERRICK CHALK
 06/17/2017 PRN288431
KRISTINA N. CHAMIS
 05/04/2023 PRN301308
DANIEL HARRIS CHAVENSON
 08/30/2018 PRN315981
KENYA J. CONLEY
 05/14/2019 PRN331048
RYAN DORSEY
 10/10/2018 PRN319029
CHRISTIAN J. GUNSTON
 11/13/2019 PRN343929
DAWN HATHAWAY
 06/17/2017 PRN288441
ARTEM BORISOVICH ILINETS
 05/14/2019 PRN331052
PAVLOS MYROFTSALIS
 03/18/2020 PRN351215
JULIE N. NOONAN
 02/15/2020 PRN349393
WILLYE G. ROWLAND
 04/17/2019 PRN329702
JEFFREY M. SAMUELS
 04/17/2019 PRN329715
JOHN SANDSTROM
 01/14/2020 PRN347400
DEBORAH D. SASAK
 04/17/2019 PRN329709
JUSTIN SORENSEN
 02/26/2020 PRN349995
JOSEPH WASSERMAN
 10/10/2018 PRN319030
KEIRSTIN WESTFALLEN
 11/26/2019 PRN344919

Branch Office

None.

Supervised Entity

None.

Responsible Individual
Name License Number
JULIE N. NOONAN PRN349393

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
17701177

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/13/2025 12:26:37 PM