Individual ProviderIkimot AjiboseBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address3160 Crow Canyon Pl Ste 205, San Ramon, CA 94583-1338(818) 241-6780PECOS EnrollmentBased on the most recent information from CMS, provider Ikimot Ajibose 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 10:34 AM.Profile DetailsProvider ID1407333974Provider TypeIndividualFull NameAjibose, IkimotGenderFemaleSole ProprietorNoEnumeration Date7/26/2018Last Updated7/26/2018Contact InformationPractice LocationPractice Address3160 Crow Canyon Pl Ste 205, San Ramon, CA 94583-1338Phone(818) 241-6780FaxUnlisted FaxMailing LocationMailing Address206 N Jackson St Ste 202, Glendale, CA 91206-4330Phone(818) 241-6780FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer