Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053295204 Individual Practitioner Male Practitioner

Mark Allen Bourassa

Counselor - Professional • Stockton, CA

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Mark Bourassa is a registered healthcare professional specializing in Counselor - Professional in Stockton, CA. Official NPI practice address is registered at 1305 TOMMYDON ST.

Practice Location & Contact Primary Location

Practice Address

1305 Tommydon St

Stockton, CA 952103364

Telephone 8552684096

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Stockton, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.5 Yrs
State Avg: 10.8 Yrs
Regional Practice Density
68 Specialists

Practicing in Stockton, CA (4040 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-08-04
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CA 22719

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Panhia Lo , LMFT

Marriage & Family Therapist

NPI 1144721416

Licensed Marriage and Family Therapist

Peggy Lingard , LCSW

Social Worker - Clinical

NPI 1194881136

Licensed Clinical Social Worker

Brooke Vierra , LMFT

Marriage & Family Therapist

NPI 1699108076

Licensed Marriage and Family Therapist

Sharonna Carson , COUNSELOR

Counselor - Addiction (Substance Use Disorder)

NPI 1730643289
Lisa Ramirez

Marriage & Family Therapist

NPI 1861324600

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2026

Counselor (License #22719 in CA)

NPI Profile Active August 01, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location August 01, 2025

Registered at 1305 TOMMYDON ST, STOCKTON, CA 952103364 (Tel: 8552684096)

📍
Updated Business Mailing Address August 01, 2025

Registered at 1620 G ST APT 17, SACRAMENTO, CA 958141632 (Tel: 9168574451)

👤
Provider Name / Credentials Updated August 01, 2025

Recorded as MARK BOURASSA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2025

Counselor (License #15046 in CA)

🟢
Initial NPI Registration & Enumeration August 01, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053295204
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 01, 2025
Last Update: August 04, 2026
Sole Proprietor: No

Mailing Address

1620 G St Apt 17

Sacramento, CA 958141632

Phone: 9168574451

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.