Maryjane Domenique Padilla | Lancaster, CA • PECOS Search

Maryjane Domenique Padilla

Case Manager/Care Coordinator

Other Service Providers

1331 W Avenue J, Lancaster, CA 93534-2942

(661) 940-9094 (818) 331-8503

PECOS Enrollment

Based on the most recent information from CMS, provider Maryjane Domenique Padilla 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
1881233955
Provider Type
Individual
Full Name
Padilla, Maryjane Domenique
Gender
Female

Sole Proprietor
No
Enumeration Date
1/6/2020
Last Updated
1/6/2020

Contact Information

Practice Location

1331 W Avenue J, Lancaster, CA 93534-2942

Unlisted Fax

Mailing Location

44107 Kirkland Ave, Lancaster, CA 93535-3656

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer