Individual ProviderStacey EscamillaBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529(951) 525-1990PECOS EnrollmentBased on the most recent information from CMS, provider Stacey Escamilla 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 ID1194419069Provider TypeIndividualFull NameEscamilla, StaceyGenderFemaleSole ProprietorYesEnumeration Date6/5/2023Last Updated6/5/2023Contact InformationPractice LocationPractice Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529Phone(951) 525-1990FaxUnlisted FaxMailing LocationMailing Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529Phone(951) 525-1990FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer