Individual ProviderJazlyn Alexa LopezBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address12125 Day St, Moreno Valley, CA 92557-6702(951) 344-2166(951) 391-7784PECOS EnrollmentBased on the most recent information from CMS, provider Jazlyn Alexa Lopez 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 2 days ago.Profile DetailsProvider ID1902663263Provider TypeIndividualFull NameLopez, Jazlyn AlexaGenderFemaleSole ProprietorNoEnumeration Date3/4/2024Last Updated3/4/2024Contact InformationPractice LocationPractice Address12125 Day St, Moreno Valley, CA 92557-6702Phone(951) 344-2166FaxUnlisted FaxMailing LocationMailing Address10644 Ridgefield Ter, Moreno Valley, CA 92557-3805Phone(951) 391-7784FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCalifornia