Courtney Logan | San Ramon, CA • PECOS Search

Courtney Logan

Behavior Technician

Behavioral Health & Social Service Providers

3160 Crow Canyon Pl Ste 205, San Ramon, CA 94583-1338

PECOS Enrollment

Based on the most recent information from CMS, provider Courtney Logan 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
1841754116
Provider Type
Individual
Full Name
Logan, Courtney
Gender
Female

Sole Proprietor
No
Enumeration Date
1/30/2019
Last Updated
1/30/2019

Contact Information

Practice Location

3160 Crow Canyon Pl Ste 205, San Ramon, CA 94583-1338

Unlisted Fax

Mailing Location

206 N Jackson St Ste 202, Glendale, CA 91206-4330

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer