| Sonoma Therapy Network | |
|
3438 Mendocino Ave Ste B Santa Rosa CA 95403-2275 | |
| (707) 387-4525 | |
| (707) 843-5574 |
| Full Name | Sonoma Therapy Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 3438 Mendocino Ave Ste B, Santa Rosa, California |
| Authorized Official Name and Position | Garet David Waterhouse (OWNER) |
| Authorized Official Contact | 7073874525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sonoma Therapy Network 3438 Mendocino Ave Ste B Santa Rosa CA 95403-2275 Ph: (707) 387-4525 | Sonoma Therapy Network 3438 Mendocino Ave Ste B Santa Rosa CA 95403-2275 Ph: (707) 387-4525 |
| NPI Number | 1356854673 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 05/19/2022 |
| Certification Date | 05/19/2022 |
| Medicare PECOS PAC ID | 1759633357 |
|---|---|
| Medicare Enrollment ID | O20181009003637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356854673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Garet D Waterhouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447425913 PECOS PAC ID: 1557660099 Enrollment ID: I20160504001201 |
| Provider Name | Suzanne Yeomans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710330311 PECOS PAC ID: 0648698902 Enrollment ID: I20200908002453 |
| Provider Name | Clara Isela Flor-vera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639941065 PECOS PAC ID: 1557719341 Enrollment ID: I20231205001931 |
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