Jessica Marie Grose | San Diego, CA • PECOS Search

Jessica Marie Grose

Behavior Technician

Behavioral Health & Social Service Providers

9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324

(858) 505-9083 (760) 737-3990

PECOS Enrollment

Based on the most recent information from CMS, provider Jessica Marie Grose 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
1104383793
Provider Type
Individual
Full Name
Grose, Jessica Marie
Gender
Female

Sole Proprietor
No
Enumeration Date
3/1/2019
Last Updated
2/12/2021

Contact Information

Practice Location

9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324

Unlisted Fax

Mailing Location

401 S Ivy St, Escondido, CA 92025-4339

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer