| Mr Mark Gerald Koch, MFT | |
| 
					2101 Courage Dr, Fairfield, CA 94533-6717  | |
| (707) 784-2099 | |
| Not Available | 
| Full Name | Mr Mark Gerald Koch | 
|---|---|
| Gender | Male | 
| Speciality | Marriage & Family Therapist | 
| Location | 2101 Courage Dr, Fairfield, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1396808622 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC33411 (California) | Primary | 
| Entity Name | Grow Healthcare Group Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mr Mark Gerald Koch, MFT 2101 Courage Dr, Fairfield, CA 94533-6717 Ph: (707) 784-2099  | Mr Mark Gerald Koch, MFT 2101 Courage Dr, Fairfield, CA 94533-6717 Ph: (707) 784-2099  | 
Mrs. Charlin Amber Lumia, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 801 Empire St, Fairfield, CA 94533 Phone: 707-425-5744  | |
Matthew Ryan Jezierski, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 4820 Business Center Dr Ste 210, Fairfield, CA 94534 Phone: 707-224-8266  | |
Katrina Copeland, MFTI Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 275 Beck Ave # Ms 5-250, Fairfield, CA 94533 Phone: 707-784-8337  | |
Marco Antonio Sanchez, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 675 Texas St Ste 3800, Fairfield, CA 94533 Phone: 916-715-5930 Fax: 707-427-2784  | |
Cyndi Carol Smit, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2101 Courage Dr, Fairfield, CA 94533 Phone: 707-784-2224  | |
Ms. Melanie Dawn Cook, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 2101 Courage Dr, Fairfield, CA 94533 Phone: 707-784-2152 Fax: 707-784-2269  | |
Paul Severino Bright, MFT-I Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1771 Barton Dr, Fairfield, CA 94534 Phone: 707-648-8121  |