Individual ProviderAlexander KondrakhinSocial WorkerBehavioral Health & Social Service ProvidersPractice Address290 N 2nd St, San Jose, CA 95112-4143(408) 813-9637PECOS EnrollmentBased on the most recent information from CMS, provider Alexander Kondrakhin 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 ID1114640620Provider TypeIndividualFull NameKondrakhin, AlexanderGenderMaleSole ProprietorNoEnumeration Date9/20/2022Last Updated9/20/2022Contact InformationPractice LocationPractice Address290 N 2nd St, San Jose, CA 95112-4143Phone(408) 813-9637FaxUnlisted FaxMailing LocationMailing Address290 N 2nd St, San Jose, CA 95112-4143PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer