Jared Krutka | Stockton, CA • PECOS Search

Jared Krutka

Counselor

Behavioral Health & Social Service Providers

1212 N California St, Stockton, CA 95202-1552

(209) 468-8700 (209) 986-3454

PECOS Enrollment

Based on the most recent information from CMS, provider Jared Krutka 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 yesterday at 12:57 PM.

Profile Details

Provider ID
1295157105
Provider Type
Individual
Full Name
Krutka, Jared
Gender
Male

Sole Proprietor
No
Enumeration Date
1/11/2014
Last Updated
1/11/2014

Contact Information

Practice Location

1212 N California St, Stockton, CA 95202-1552

Unlisted Fax

Mailing Location

8811 Deer Creek Cir, Stockton, CA 95210-4464

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer