Jillian Elizabeth Harrell | San Jose, CA • PECOS Search

Jillian Elizabeth Harrell

Social Worker

Behavioral Health & Social Service Providers

210 N. Fourth St, Suite 100, San Jose, CA 95112

(408) 295-5288 (408) 454-4300

PECOS Enrollment

Based on the most recent information from CMS, provider Jillian Elizabeth Harrell 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
1275733289
Provider Type
Individual
Full Name
Harrell, Jillian Elizabeth
Credential
ASW

Gender
Female
Sole Proprietor
No
Enumeration Date
7/19/2007
Last Updated
7/19/2007

Contact Information

Practice Location

210 N. Fourth St, Suite 100, San Jose, CA 95112

(408) 292-1029

Mailing Location

900 Pepper Tree Ln Apt 314, Santa Clara, CA 95051-5279

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 22004 California