Provider Demographics
NPI:1518178748
Name:CRETCHER, WILLIAM W (RAS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:W
Last Name:CRETCHER
Suffix:
Gender:M
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CLEVELAND AVENUE, # B
Mailing Address - Street 2:SANTA ROSA TREATMENT PROGRAM
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401
Mailing Address - Country:US
Mailing Address - Phone:707-576-0818
Mailing Address - Fax:707-576-7845
Practice Address - Street 1:1901 CLEVELAND AVENUE, # B
Practice Address - Street 2:SANTA ROSA TREATMENT PROGRAM
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401
Practice Address - Country:US
Practice Address - Phone:707-566-0170
Practice Address - Fax:707-568-5445
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CARAS C0412271240101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)