Provider Demographics
NPI:1962932129
Name:POYSER, MATTHEW
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:POYSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 ANDREUX ST #106
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-4819
Mailing Address - Country:US
Mailing Address - Phone:707-991-6966
Mailing Address - Fax:707-581-1766
Practice Address - Street 1:181 ANDREUX ST #106
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-4819
Practice Address - Country:US
Practice Address - Phone:707-991-6966
Practice Address - Fax:707-581-1766
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8241237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist