Kimberlee Gourlay | Moreno Valley, CA • PECOS Search

Kimberlee Gourlay

Behavior Technician

Behavioral Health & Social Service Providers

24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529

(951) 992-3227 (909) 462-2566

PECOS Enrollment

Based on the most recent information from CMS, provider Kimberlee Gourlay 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 2 days ago.

Profile Details

Provider ID
1285413633
Provider Type
Individual
Full Name
Gourlay, Kimberlee
Gender
Female

Sole Proprietor
Yes
Enumeration Date
9/25/2023
Last Updated
9/25/2023

Contact Information

Practice Location

24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529

Unlisted Fax

Mailing Location

8666 Newport Ave, Fontana, CA 92335-3822

Unlisted Fax

Provider Taxonomies

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