Individual ProviderMarcy John DacosteSocial WorkerBehavioral Health & Social Service ProvidersPractice Address25 Chumalia St, San Leandro, CA 94577-4545(510) 595-2567PECOS EnrollmentBased on the most recent information from CMS, provider Marcy John Dacoste 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 ID1760667406Provider TypeIndividualFull NameDacoste, Marcy JohnTitleMr.GenderMaleSole ProprietorYesEnumeration Date12/31/2007Last Updated12/31/2007Contact InformationPractice LocationPractice Address25 Chumalia St, San Leandro, CA 94577-4545Phone(510) 595-2567FaxUnlisted FaxMailing LocationMailing Address25 Chumalia St, San Leandro, CA 94577-4545Phone(510) 595-2567FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense3447CaliforniaCode106H00000XDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense5617California