Mark Scott Demanes, PH.D., MFT

Individual provider Active NPI Marriage & Family Therapist · Copperopolis, CA

NPI 1891975108 · NPPES record last updated Nov 5, 2007

Key facts

NPI
1891975108
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC27768 (CA)
Practice address
120 Athena Dr
Copperopolis, CA 95228-9329
Phone
(510) 435-5298
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC27768CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC27768 CA Yes

Addresses

Primary practice location

120 Athena Dr
Copperopolis, CA 95228-9329

Mailing address

120 Athena Drive
Copperopolis, CA 95228
Phone (510) 435-5298

Other providers in Copperopolis, CA

All providers in Copperopolis, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.