Individual ProviderKimberly ChavezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address232 E Gish Rd, San Jose, CA 95112-4706(408) 876-4284PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Chavez 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 ID1952964850Provider TypeIndividualFull NameChavez, KimberlyGenderFemaleSole ProprietorNoEnumeration Date4/16/2019Last Updated4/27/2023Contact InformationPractice LocationPractice Address232 E Gish Rd, San Jose, CA 95112-4706Phone(408) 876-4284FaxUnlisted FaxMailing LocationMailing Address232 E Gish Rd, San Jose, CA 95112-4706Phone(408) 876-4284FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense102275CaliforniaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer