Individual ProviderCasey D MixonBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324(858) 505-9083PECOS EnrollmentBased on the most recent information from CMS, provider Casey D Mixon 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 ID1164161584Provider TypeIndividualFull NameMixon, Casey DGenderFemaleSole ProprietorNoEnumeration Date6/2/2022Last Updated6/2/2022Contact InformationPractice LocationPractice Address9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324Phone(858) 505-9083FaxUnlisted FaxMailing LocationMailing Address9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer