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Vanessa Vazquez

Marriage & Family Therapist

Behavioral Health & Social Service Providers

12625 Hesperia Rd, Victorville, CA 92395-7720

PECOS Enrollment

This provider is enrolled in PECOS as VANESSA MASTANDREA.

Based on the most recent information from CMS, provider Vanessa Vazquez is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1306535273
Provider Type
Individual
Full Name
Vazquez, Vanessa
Gender
Female

Sole Proprietor
No
Enumeration Date
5/4/2023
Last Updated
12/6/2023

Contact Information

Practice Location

12625 Hesperia Rd, Victorville, CA 92395-7720

(760) 995-8385

Unlisted Fax

Mailing Location

12625 Hesperia Rd, Victorville, CA 92395-7720

(760) 995-8385

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 142132 California
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 142132 California
Code 171M00000X	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer

Vanessa Vazquez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Schweitzer, B

Gonzalez, Synthia Monique

Darnell, Melissa Christine

Esquivel, Sylvia Ines

Eisenhart, Susanne

Barbieri, Joanne C.

Tamayo Manrique, Nelcy Yohanna

Small, Tracy

Johnson, Kasha M

Licon, Joseph