Individual ProviderJesse A GomezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address290 N 2nd St, San Jose, CA 95112-4143(408) 398-6241PECOS EnrollmentBased on the most recent information from CMS, provider Jesse A Gomez 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 ID1770112625Provider TypeIndividualFull NameGomez, Jesse AGenderMaleSole ProprietorYesEnumeration Date4/3/2020Last Updated4/3/2020Contact InformationPractice LocationPractice Address290 N 2nd St, San Jose, CA 95112-4143Phone(408) 398-6241FaxUnlisted FaxMailing LocationMailing Address290 N 2nd St, San Jose, CA 95112-4143Phone(408) 398-6241FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode225800000XDescriptionRecreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer