Individual ProviderCrystal MaravillaAdult CompanionNursing Service Related ProvidersPractice Address121 Downey Ave, Modesto, CA 95354-1208(209) 341-1824PECOS EnrollmentBased on the most recent information from CMS, provider Crystal Maravilla 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 ID1417724923Provider TypeIndividualFull NameMaravilla, CrystalGenderFemaleSole ProprietorNoEnumeration Date12/5/2023Last Updated5/27/2025Contact InformationPractice LocationPractice Address121 Downey Ave, Modesto, CA 95354-1208Phone(209) 341-1824FaxUnlisted FaxMailing LocationMailing Address121 Downey Ave, Modesto, CA 95354-1208PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode372600000XPrimaryDescriptionAdult CompanionNursing Service Related ProvidersLicenseUnlisted IssuerCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer