Earl Boisclair | Santa Rosa, CA • PECOS Search

Earl Boisclair

Counselor

Behavioral Health & Social Service Providers

2470 Lemur St, Santa Rosa, CA 95401-6743

PECOS Enrollment

Based on the most recent information from CMS, provider Earl Boisclair does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1255725495
Provider Type
Individual
Full Name
Boisclair, Earl
Gender
Male

Sole Proprietor
No
Enumeration Date
3/25/2015
Last Updated
3/25/2015

Contact Information

Practice Location

2470 Lemur St, Santa Rosa, CA 95401-6743

Unlisted Fax

Mailing Location

2470 Lemur St, Santa Rosa, CA 95401-6743

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer