Individual ProviderSamantha NicholasBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address584 E Bellevue Rd, Atwater, CA 95301-2300(559) 747-2177PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Nicholas 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 11:02 AM.Profile DetailsProvider ID1609460856Provider TypeIndividualFull NameNicholas, SamanthaGenderFemaleSole ProprietorNoEnumeration Date2/26/2021Last Updated2/26/2021Contact InformationPractice LocationPractice Address584 E Bellevue Rd, Atwater, CA 95301-2300Phone(559) 747-2177FaxUnlisted FaxMailing LocationMailing Address584 E Bellevue Rd, Atwater, CA 95301-2300Phone(559) 747-2177FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer