Individual ProviderJestina ClarkBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address110 Ryan Industrial Ct Ste 3&4, San Ramon, CA 94583-1592(510) 315-6600PECOS EnrollmentBased on the most recent information from CMS, provider Jestina Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:34 AM.Profile DetailsProvider ID1003627860Provider TypeIndividualFull NameClark, JestinaGenderFemaleSole ProprietorNoEnumeration Date1/20/2025Last Updated1/20/2025Contact InformationPractice LocationPractice Address110 Ryan Industrial Ct Ste 3&4, San Ramon, CA 94583-1592Phone(510) 315-6600FaxUnlisted FaxMailing LocationMailing Address110 Ryan Industrial Ct Ste 3&4, San Ramon, CA 94583-1592Phone(510) 315-6600FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer