Individual ProviderJesse JuarezCounselorBehavioral Health & Social Service ProvidersPractice Address934 N Mountain Ave, Ste C, Upland, CA 91786-3659(909) 579-8100PECOS EnrollmentBased on the most recent information from CMS, provider Jesse Juarez 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 ID1629107644Provider TypeIndividualFull NameJuarez, JesseGenderMaleSole ProprietorYesEnumeration Date3/5/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address934 N Mountain Ave, Ste C, Upland, CA 91786-3659Phone(909) 579-8100Fax(909) 579-8149Mailing LocationMailing Address934 N Mountain Ave, Ste C, Upland, CA 91786-3659Phone(909) 579-8100Fax(909) 579-8149Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer