Daceia A Malone | San Jose, CA • PECOS Search

Daceia A Malone

Social Worker

Behavioral Health & Social Service Providers

232 E Gish Rd, San Jose, CA 95112-4706

PECOS Enrollment

Based on the most recent information from CMS, provider Daceia A Malone 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
1073687794
Provider Type
Individual
Full Name
Malone, Daceia A
Credential
MS

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/17/2006
Last Updated
7/8/2007

Contact Information

Practice Location

232 E Gish Rd, San Jose, CA 95112-4706

Unlisted Fax

Mailing Location

232 E Gish Rd, San Jose, CA 95112-4706

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer