Individual ProviderJoseph LiconMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address13261 Spring Valley Parkway, Ste 205, Victorville, CA 92395(442) 243-2714PECOS EnrollmentBased on the most recent information from CMS, provider Joseph Licon 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 ID1831963685Provider TypeIndividualFull NameLicon, JosephGenderMaleSole ProprietorYesEnumeration Date11/13/2023Last Updated11/13/2023Contact InformationPractice LocationPractice Address13261 Spring Valley Parkway, Ste 205, Victorville, CA 92395Phone(442) 243-2714FaxUnlisted FaxMailing LocationMailing AddressPO Box 9402, Redlands, CA 92375-2602PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense137300CaliforniaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer