Dr Charles William Pengra, PHD - Psychologist in Santa Rosa, CA

Dr Charles William Pengra, PHD is a Psychologist based in Santa Rosa, California. Dr Charles William Pengra is licensed to practice in California (license number PSY 6754) and his current practice location is 722 Spring St, Ste. 1, Santa Rosa, California. He can be reached at his office (for appointments etc.) via phone at (707) 583-2360.

NPI number for Dr Charles William Pengra is 1093738619 and his current mailing address is 722 Spring St, Ste. 1, Santa Rosa, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093738619.

Contact Information

Dr Charles William Pengra, PHD
722 Spring St, Ste. 1,
Santa Rosa, CA 95404-3902
(707) 583-2360
(707) 544-0825



Healthcare Provider's Profile

Full NameDr Charles William Pengra
GenderMale
SpecialityPsychologist
Location722 Spring St, Santa Rosa, California
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1093738619
  • Provider Enumeration Date: 07/25/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Charles William Pengra such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093738619NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist PSY 6754 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charles William Pengra is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Charles William Pengra, PHD
722 Spring St, Ste. 1,
Santa Rosa, CA 95404-3902

Ph: (707) 583-2360
Dr Charles William Pengra, PHD
722 Spring St, Ste. 1,
Santa Rosa, CA 95404-3902

Ph: (707) 583-2360

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› Verified 8 days ago


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