Individual ProviderDanielle MataCounselorBehavioral Health & Social Service ProvidersPractice Address1212 N California St, Stockton, CA 95202-1552(209) 468-8867PECOS EnrollmentBased on the most recent information from CMS, provider Danielle Mata 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 ID1265858963Provider TypeIndividualFull NameMata, DanielleGenderFemaleSole ProprietorYesEnumeration Date3/5/2014Last Updated3/5/2014Contact InformationPractice LocationPractice Address1212 N California St, Stockton, CA 95202-1552Phone(209) 468-8867FaxUnlisted FaxMailing LocationMailing Address1212 N California St, Stockton, CA 95202-1552PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer