Individual ProviderJessica KinonMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address1421 Guerneville Rd Ste 218, Santa Rosa, CA 95403-7255(707) 576-7700PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Kinon 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 3 days ago.Profile DetailsProvider ID1932545142Provider TypeIndividualFull NameKinon, JessicaGenderFemaleSole ProprietorNoEnumeration Date5/14/2013Last Updated8/10/2015Contact InformationPractice LocationPractice Address1421 Guerneville Rd Ste 218, Santa Rosa, CA 95403-7255Phone(707) 576-7700FaxUnlisted FaxMailing LocationMailing Address1421 Guerneville Rd Ste 218, Santa Rosa, CA 95403-7255Phone(707) 576-7700FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseIMF74165California