Jerome Everette Watson | Victorville, CA • PECOS Search

Jerome Everette Watson

Marriage & Family Therapist

Behavioral Health & Social Service Providers

12180 Ridgecrest Rd Ste 402a, Victorville, CA 92395-5902

(760) 881-3558 (909) 915-4998

PECOS Enrollment

Based on the most recent information from CMS, provider Jerome Everette Watson 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
1861787277
Provider Type
Individual
Full Name
Watson, Jerome Everette
Title
Mr.
Credential
LMFT

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/14/2011
Last Updated
4/4/2018

Contact Information

Practice Location

12180 Ridgecrest Rd Ste 402a, Victorville, CA 92395-5902

(760) 881-3457

Mailing Location

16333 Green Tree Blvd Unit 2673, Victorville, CA 92393-7108

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License MFC 48090 California