MEDICARE: MRS. CARMEN ANCINAS-GEE MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	32843	CA

General Provider Information

NPI Number	:	1013075035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARMEN ANCINAS-GEE MFT

Provider Business Mailing Address
First Line	:	2213 BUCHANAN RD
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94509-4265
Country	:	US
Telephone Number	:	925-779-4964
Fax Number	:

Provider Business Practice Location Address
First Line	:	2213 BUCHANAN RD
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94509-4265
Country	:	US
Telephone Number	:	925-779-4964
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	12/30/2021

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