Individual ProviderJennelyn LopezBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address12125 Day St Unit E301, Moreno, CA 92557(951) 344-2166PECOS EnrollmentBased on the most recent information from CMS, provider Jennelyn Lopez 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 2 days ago.Profile DetailsProvider ID1033895982Provider TypeIndividualFull NameLopez, JennelynGenderFemaleSole ProprietorNoEnumeration Date6/26/2023Last Updated6/26/2023Contact InformationPractice LocationPractice Address12125 Day St Unit E301, Moreno, CA 92557Phone(951) 344-2166FaxUnlisted FaxMailing LocationMailing Address5850 Granite Parkway Suite 600, Plano, TX 75024PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer