Individual ProviderKevin Austin ChurchillCounselorBehavioral Health & Social Service ProvidersPractice Address1212 N California St, Stockton, CA 95202-1552(209) 468-0102PECOS EnrollmentBased on the most recent information from CMS, provider Kevin Austin Churchill 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 12:57 PM.Profile DetailsProvider ID1053822841Provider TypeIndividualFull NameChurchill, Kevin AustinGenderMaleSole ProprietorYesEnumeration Date10/19/2017Last Updated10/19/2017Contact InformationPractice LocationPractice Address1212 N California St, Stockton, CA 95202-1552Phone(209) 468-0102Fax(209) 468-2380Mailing LocationMailing Address1212 N California St, Stockton, CA 95202-1552Phone(209) 468-0102Fax(209) 468-2380Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense40640California