Individual ProviderKaren Nicole De JesusMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address4700 Spring St Ste 203, La Mesa, CA 91942-0273(619) 549-0329PECOS EnrollmentBased on the most recent information from CMS, provider Karen Nicole De Jesus 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 3 days ago.Profile DetailsProvider ID1851037345Provider TypeIndividualFull NameDe Jesus, Karen NicoleGenderFemaleSole ProprietorYesEnumeration Date5/9/2022Last Updated6/18/2024Contact InformationPractice LocationPractice Address4700 Spring St Ste 203, La Mesa, CA 91942-0273Phone(619) 549-0329FaxUnlisted FaxMailing LocationMailing Address4700 Spring St Ste 203, La Mesa, CA 91942-0273Phone(619) 549-0329FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense143061CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer