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Jeannine Mardi Daleo

Marriage & Family Therapist

Behavioral Health & Social Service Providers

4700 Spring St, Ste 220, La Mesa, CA 91942-0263

PECOS Enrollment

This provider is enrolled in PECOS as JEANNINE DALEO.

Based on the most recent information from CMS, provider Jeannine Mardi Daleo is legally eligible to order and refer claims for Part B and DME services only.

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

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1780625160
Provider Type
Individual
Full Name
Daleo, Jeannine Mardi
Credential
MFT

Gender
Female
Sole Proprietor
No
Enumeration Date
6/9/2006
Last Updated
1/11/2022

Contact Information

Practice Location

4700 Spring St, Ste 220, La Mesa, CA 91942-0263

(619) 667-3380

(619) 667-0815

Mailing Location

3554 Round Barn Blvd, Santa Rosa, CA 95403-0929

(619) 528-4600

(619) 528-4625

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFC38634 California

Jeannine Mardi Daleo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

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Code

Description

License

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