Individual ProviderMark FieldsonMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address4132 Katella Ave, 104, Los Alamitos, CA 90720-3426(562) 754-3005PECOS EnrollmentBased on the most recent information from CMS, provider Mark Fieldson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1225196454Provider TypeIndividualFull NameFieldson, MarkTitleMr.CredentialM.F.T.GenderMaleSole ProprietorYesEnumeration Date12/4/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address4132 Katella Ave, 104, Los Alamitos, CA 90720-3426Phone(562) 754-3005Fax(562) 598-5997Mailing LocationMailing Address12875 Martha Ann Dr, Los Alamitos, CA 90720-4923Phone(562) 754-3005Fax(562) 598-5997Provider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC25467California