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NPI Code Detail

MEDICARE: MRS. FREDERIQUE EUGENIE MARKS CAADC

MEDICARE: MRS. FREDERIQUE EUGENIE MARKS CAADC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorA3697493CA

General Provider Information

NPI Number : 1699812834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FREDERIQUE EUGENIE MARKS CAADC
Provider Business Mailing Address
First Line : 8283 LANCASTER DR
Second Line :
City : ROHNERT PARK
State : CA
Zip : 94928-2800
Country : US
Telephone Number : 707-792-1969
Fax Number :
Provider Business Practice Location Address
First Line : 2344 OLD SONOMA RD BLDG J
Second Line :
City : NAPA
State : CA
Zip : 94559-3708
Country : US
Telephone Number : 707-259-8769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 01/11/2026

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