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Kenne William Kennemer

Marriage & Family Therapist

Behavioral Health & Social Service Providers

2403 Professional Dr, Suite 101, Santa Rosa, CA 95403-3007

PECOS Enrollment

This provider is enrolled in PECOS as KENNE KENNEMER.

Based on the most recent information from CMS, provider Kenne William Kennemer is legally eligible to order and refer claims for Part B and DME services only.

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

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1114121621
Provider Type
Individual
Full Name
Kennemer, Kenne William
Credential
MFT

Gender
Male
Sole Proprietor
No
Enumeration Date
6/11/2007
Last Updated
7/8/2007

Contact Information

Practice Location

2403 Professional Dr, Suite 101, Santa Rosa, CA 95403-3007

(707) 544-3295

(707) 544-9011

Mailing Location

2403 Professional Dr, Suite 101, Santa Rosa, CA 95403-3007

(707) 544-3295

(707) 544-9011

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License Unlisted Issuer

Kenne William Kennemer

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Blake, Eylin Margarita

Hall, Kris

Bromley, George William

Lutchansky, Cameron Craig

Delmonte, Anne

Margolis, Paul E.

Cutler, Theresa Ann

Joy, Maitri Dasa

Privette, Thea A.

Hutchens, Lynda I