Lori Rose Theno | Victorville, CA • PECOS Search

Lori Rose Theno

Marriage & Family Therapist

Behavioral Health & Social Service Providers

14360 Saint Andrews Dr Ste 11, Victorville, CA 92395-4341

PECOS Enrollment

Based on the most recent information from CMS, provider Lori Rose Theno does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1750540548
Provider Type
Individual
Full Name
Theno, Lori Rose
Title
Ms.
Credential
MFT INTERN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/5/2008
Last Updated
6/5/2008

Contact Information

Practice Location

14360 Saint Andrews Dr Ste 11, Victorville, CA 92395-4341

(760) 245-5896

Mailing Location

14360 Saint Andrews Dr Ste 11, Victorville, CA 92395-4341

(760) 245-5896

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 55689 California