Individual ProviderJonathan ShiromaMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address8280 La Mesa Blvd Ste 7, La Mesa, CA 91942-6208(619) 535-8709PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Shiroma 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 3 days ago.Profile DetailsProvider ID1457122301Provider TypeIndividualFull NameShiroma, JonathanCredentialAMFTGenderMaleSole ProprietorNoEnumeration Date1/10/2024Last Updated2/19/2024Contact InformationPractice LocationPractice Address8280 La Mesa Blvd Ste 7, La Mesa, CA 91942-6208Phone(619) 535-8709FaxUnlisted FaxMailing LocationMailing Address8280 La Mesa Blvd Ste 7, La Mesa, CA 91942-6208Phone(619) 535-8709FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense144423CaliforniaCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer