Individual ProviderJacqunisha Wa SmithNon-emergency Medical Transport (VAN)Transportation ServicesPractice Address4081 Dale Rd Apt D, Modesto, CA 95356-9609(650) 501-2160PECOS EnrollmentBased on the most recent information from CMS, provider Jacqunisha Wa Smith 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 ID1598615338Provider TypeIndividualFull NameSmith, Jacqunisha WaGenderFemaleSole ProprietorYesEnumeration Date1/31/2026Last Updated1/31/2026Contact InformationPractice LocationPractice Address4081 Dale Rd Apt D, Modesto, CA 95356-9609Phone(650) 501-2160FaxUnlisted FaxMailing LocationMailing Address4081 Dale Rd Apt D, Modesto, CA 95356-9609Phone(650) 501-2160FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode343900000XPrimaryDescriptionNon-emergency Medical Transport (VAN)Transportation ServicesLicenseUnlisted IssuerCalifornia