Individual ProviderDaniel BedollaMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address12421 Hesperia Rd, Victorville, CA 92395-7703(760) 243-5417PECOS EnrollmentBased on the most recent information from CMS, provider Daniel Bedolla 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 ID1609273895Provider TypeIndividualFull NameBedolla, DanielGenderMaleSole ProprietorNoEnumeration Date12/3/2014Last Updated4/15/2025Contact InformationPractice LocationPractice Address12421 Hesperia Rd, Victorville, CA 92395-7703Phone(760) 243-5417FaxUnlisted FaxMailing LocationMailing Address12421 Hesperia Rd, Victorville, CA 92395-7703Phone(760) 243-5417FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense140921CaliforniaCode373H00000XDescriptionDay Training/Habilitation SpecialistNursing Service Related ProvidersLicenseUnlisted Issuer