Jeffery Scott Larson | Stockton, CA • PECOS Search

Jeffery Scott Larson

Counselor

Behavioral Health & Social Service Providers

1212 N California St, Stockton, CA 95202-1552

PECOS Enrollment

Based on the most recent information from CMS, provider Jeffery Scott Larson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1043596869
Provider Type
Individual
Full Name
Larson, Jeffery Scott
Title
Mr.

Gender
Male
Sole Proprietor
No
Enumeration Date
10/25/2011
Last Updated
10/25/2011

Contact Information

Practice Location

1212 N California St, Stockton, CA 95202-1552

Unlisted Fax

Mailing Location

1212 N California St, Stockton, CA 95202-1552

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer