Provider Demographics
NPI:1932069028
Name:MAROLLA-TURNER, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:MAROLLA-TURNER
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 1:1291 BUSINESS CENTER DR UNIT M201
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-2562
Mailing Address - Country:US
Mailing Address - Phone:774-688-1737
Mailing Address - Fax:
Practice Address - Street 1:1101 ALBERTA WAY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3747
Practice Address - Country:US
Practice Address - Phone:925-682-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor