John Joseph Vaughan | Santa Rosa, CA • PECOS Search

John Joseph Vaughan

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 John Joseph Vaughan 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
1992232680
Provider Type
Individual
Full Name
Vaughan, John Joseph
Title
Mr.

Gender
Male
Sole Proprietor
No
Enumeration Date
5/12/2017
Last Updated
5/12/2017

Contact Information

Practice Location

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

Unlisted Fax

Mailing Location

9308 Champs De Elysees, Forestville, CA 95436-9518

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License R1251570517 California