Provider Demographics
NPI:1881898146
Name:GEE, MARK A (MFT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:GEE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20470 CHARLOTTE CT
Mailing Address - Street 2:
Mailing Address - City:SOULSBYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95372-9724
Mailing Address - Country:US
Mailing Address - Phone:209-532-2127
Mailing Address - Fax:
Practice Address - Street 1:230 S SHEPHERD ST
Practice Address - Street 2:SUITE H
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5038
Practice Address - Country:US
Practice Address - Phone:209-768-3059
Practice Address - Fax:209-533-7007
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist