Individual ProviderCassidy Taylor Mangio-GonzalesCounselorBehavioral Health & Social Service ProvidersPractice Address1260 E Arrow Hwy, Upland, CA 91786-4982(909) 932-1069PECOS EnrollmentBased on the most recent information from CMS, provider Cassidy Taylor Mangio-Gonzales 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 4 days ago.Profile DetailsProvider ID1144821406Provider TypeIndividualFull NameMangio-Gonzales, Cassidy TaylorGenderFemaleSole ProprietorNoEnumeration Date11/3/2020Last Updated11/3/2020Contact InformationPractice LocationPractice Address1260 E Arrow Hwy, Upland, CA 91786-4982Phone(909) 932-1069FaxUnlisted FaxMailing LocationMailing Address1260 E Arrow Hwy, Upland, CA 91786-4982PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer