Individual ProviderPeggy Elaine GordonCounselorBehavioral Health & Social Service ProvidersPractice Address1212 N California St, Stockton, CA 95202-1552(209) 953-7524PECOS EnrollmentBased on the most recent information from CMS, provider Peggy Elaine Gordon 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 ID1316068430Provider TypeIndividualFull NameGordon, Peggy ElaineCredentialL.P.T.GenderFemaleSole ProprietorNoEnumeration Date4/3/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address1212 N California St, Stockton, CA 95202-1552Phone(209) 953-7524Fax(209) 953-7526Mailing LocationMailing Address1212 N California St, Stockton, CA 95202-1552Phone(209) 953-7524Fax(209) 953-7526Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicensePT29247California