Individual ProviderMyrza Elizeet OlivanBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address9620 Chesapeake Dr #105, San Diego, CA 92123(858) 505-9083PECOS EnrollmentBased on the most recent information from CMS, provider Myrza Elizeet Olivan 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 ID1417540899Provider TypeIndividualFull NameOlivan, Myrza ElizeetGenderFemaleSole ProprietorNoEnumeration Date2/16/2021Last Updated2/16/2021Contact InformationPractice LocationPractice Address9620 Chesapeake Dr #105, San Diego, CA 92123Phone(858) 505-9083FaxUnlisted FaxMailing LocationMailing Address9620 Chesapeake Dr #105, San Diego, CA 92123Phone(858) 505-9083FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-20-130961California