Individual ProviderKimberly Andrea BriscoCounselorBehavioral Health & Social Service ProvidersPractice Address5436 S Broadway, Los Angeles, CA 90037-4126(323) 234-6261(323) 779-6707PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Andrea Brisco 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 today at 9:43 AM.Profile DetailsProvider ID1013155753Provider TypeIndividualFull NameBrisco, Kimberly AndreaGenderFemaleSole ProprietorNoEnumeration Date2/3/2009Last Updated2/3/2009Contact InformationPractice LocationPractice Address5436 S Broadway, Los Angeles, CA 90037-4126Phone(323) 234-6261Fax(323) 234-6265Mailing LocationMailing Address645 E 120th St, Los Angeles, CA 90059-2721Phone(323) 779-6707FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID195709ADescriptionOtherIssuerMEDICAL