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General NPI Number Information
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NPI Number | 1063605277
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Entity Type | Individual
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Provider Name | MATT S. GEE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 1812 W BURBANK BLVD
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City | BURBANK
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State | CA
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Zip | 91506-1315
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Country | US
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Telephone | 213-446-0765
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6671
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City | SANTA ROSA
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State | CA
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Zip | 95406-0671
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Country | US
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Telephone | 707-544-7331
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Fax | 707-623-9409
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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