Provider Demographics
NPI:1104538610
Name:MCGEE, TYLER PHILIP
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:PHILIP
Last Name:MCGEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14472 MUSCADINE LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4855
Mailing Address - Country:US
Mailing Address - Phone:909-225-0368
Mailing Address - Fax:
Practice Address - Street 1:29970 TECHNOLOGY DR STE 108&212
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2645
Practice Address - Country:US
Practice Address - Phone:951-900-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist