Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Allen Bourassa

Individual provider Professional Counselor · NPI 1053295204

Mark Allen Bourassa is a Professional Counselor in Stockton, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

1305 Tommydon St
Stockton, CA 95210-3364
Phone: (855) 268-4096
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 22719 (CA)

Record details

NPI number1053295204
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 1, 2025
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026
Mailing address1620 G St Apt 17, Sacramento, CA 95814-1632

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