Individual ProviderJazmine Andrea MendozaBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529(951) 525-1990(951) 380-6402PECOS EnrollmentBased on the most recent information from CMS, provider Jazmine Andrea Mendoza 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 ID1205533981Provider TypeIndividualFull NameMendoza, Jazmine AndreaGenderFemaleSole ProprietorNoEnumeration Date2/13/2023Last Updated2/13/2023Contact InformationPractice LocationPractice Address24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529Phone(951) 525-1990FaxUnlisted FaxMailing LocationMailing Address10795 Pemberton St, Adelanto, CA 92301-3870Phone(951) 380-6402FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer