Individual ProviderNicole KingBehavior 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 Nicole King 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 ID1477119816Provider TypeIndividualFull NameKing, NicoleGenderFemaleSole ProprietorNoEnumeration Date5/10/2019Last Updated5/10/2019Contact InformationPractice LocationPractice Address3160 Crow Canyon Pl Ste 205, San Ramon, CA 94583-1338Phone(818) 241-6780FaxUnlisted FaxMailing LocationMailing Address1055 E Colorado Blvd Ste 560, Pasadena, CA 91106-2380Phone(818) 241-6780FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer