Individual ProviderJeremy LacsonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address751 S Bascom Ave, San Jose, CA 95128-2604(408) 885-5000PECOS EnrollmentBased on the most recent information from CMS, provider Jeremy Lacson 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 4 days ago.Profile DetailsProvider ID1851818215Provider TypeIndividualFull NameLacson, JeremyGenderMaleSole ProprietorNoEnumeration Date8/27/2017Last Updated4/2/2019Contact InformationPractice LocationPractice Address751 S Bascom Ave, San Jose, CA 95128-2604Phone(408) 885-5000FaxUnlisted FaxMailing LocationMailing Address4400 The Woods Dr Apt 1222, San Jose, CA 95136-3855PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense291749California