Individual ProviderJesse T CollinsCounselorBehavioral Health & Social Service ProvidersPractice Address1901 Cleveland Ave, Suite B, Santa Rosa, CA 95401-4282(707) 576-0818PECOS EnrollmentBased on the most recent information from CMS, provider Jesse T Collins 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 2 days ago.Profile DetailsProvider ID1417352659Provider TypeIndividualFull NameCollins, Jesse TGenderFemaleSole ProprietorYesEnumeration Date10/30/2014Last Updated10/30/2014Contact InformationPractice LocationPractice Address1901 Cleveland Ave, Suite B, Santa Rosa, CA 95401-4282Phone(707) 576-0818Fax(707) 576-7845Mailing LocationMailing Address1901 Cleveland Ave, Suite B, Santa Rosa, CA 95401-4282Phone(707) 576-0818Fax(707) 576-7845Provider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense5240-RCalifornia