Individual ProviderWalita PowellBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address2821 Crow Canyon Road, Suite 101, San Ramon, CA 94583(925) 364-4515PECOS EnrollmentBased on the most recent information from CMS, provider Walita Powell 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 10:34 AM.Profile DetailsProvider ID1619320181Provider TypeIndividualFull NamePowell, WalitaGenderFemaleSole ProprietorYesEnumeration Date7/19/2016Last Updated9/5/2018Contact InformationPractice LocationPractice Address2821 Crow Canyon Road, Suite 101, San Ramon, CA 94583Phone(925) 364-4515FaxUnlisted FaxMailing LocationMailing Address2821 Crow Canyon Road, Suite 101, San Ramon, CA 94583-1659Phone(925) 364-4515FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer