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1093738619
CHARLES WILLIAM PENGRA
SANTA ROSA, CA
NPI
1093738619
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: CA PSY 6754)
Enumeration Date
2006-07-25
Last Update Date
2007-07-08
Business Address
Dr. CHARLES WILLIAM PENGRA Ph.D.
722 SPRING ST STE. 1
SANTA ROSA, CA 95404-3902
Phone number: 707-583-2360
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Mailing Address
Dr. CHARLES WILLIAM PENGRA Ph.D.
722 SPRING ST STE. 1
SANTA ROSA, CA 95404-3902
Phone number: 707-583-2360
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