Individual ProviderJonathan Andrew GonzalezCase Manager/Care CoordinatorOther Service ProvidersPractice Address506 W Jackman St, Lancaster, CA 93534-2531(661) 232-3332(661) 802-3228PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Andrew Gonzalez 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 ID1043977242Provider TypeIndividualFull NameGonzalez, Jonathan AndrewGenderMaleSole ProprietorNoEnumeration Date11/22/2021Last Updated3/21/2022Contact InformationPractice LocationPractice Address506 W Jackman St, Lancaster, CA 93534-2531Phone(661) 232-3332FaxUnlisted FaxMailing LocationMailing Address506 W Jackman St, Lancaster, CA 93534-2531Phone(661) 802-3228FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer