Matthew Pfohl-Smith | Santa Rosa, CA • PECOS Search

Matthew Pfohl-Smith

Counselor

Behavioral Health & Social Service Providers

1901 Cleveland Ave Ste B, Santa Rosa, CA 95401-4298

PECOS Enrollment

Based on the most recent information from CMS, provider Matthew Pfohl-Smith 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 yesterday at 9:43 AM.

Profile Details

Provider ID
1265715122
Provider Type
Individual
Full Name
Pfohl-Smith, Matthew
Title
Mr.
Credential
RASI

Gender
Male
Sole Proprietor
No
Enumeration Date
9/27/2011
Last Updated
9/27/2011

Contact Information

Practice Location

1901 Cleveland Ave Ste B, Santa Rosa, CA 95401-4298

(707) 576-7845

Mailing Location

1901 Cleveland Ave Ste B, Santa Rosa, CA 95401-4298

(707) 576-7845

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License RASI P1008201009 California