Provider Demographics
NPI:1063605277
Name:GEE, MATT S (PHD)
Entity type:Individual
Prefix:DR
First Name:MATT
Middle Name:S
Last Name:GEE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6671
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95406-0671
Mailing Address - Country:US
Mailing Address - Phone:707-544-7331
Mailing Address - Fax:707-623-9409
Practice Address - Street 1:1812 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1315
Practice Address - Country:US
Practice Address - Phone:213-446-0765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist