Individual ProviderFabian CdevacaCase Manager/Care CoordinatorOther Service ProvidersPractice Address203 California St NE, Albuquerque, NM 87108-1802(505) 308-8296PECOS EnrollmentBased on the most recent information from CMS, provider Fabian Cdevaca 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 ID1487306502Provider TypeIndividualFull NameCdevaca, FabianGenderMaleSole ProprietorNoEnumeration Date1/20/2022Last Updated3/5/2024Contact InformationPractice LocationPractice Address203 California St NE, Albuquerque, NM 87108-1802Phone(505) 308-8296FaxUnlisted FaxMailing LocationMailing Address203 California St NE, Albuquerque, NM 87108-1802PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer