| Fuller Psychology Corporation | |
|
4225 Executive Sq Suite 1110 La Jolla CA 92037-9122 | |
| (858) 558-7707 | |
| (858) 558-7708 |
| Full Name | Fuller Psychology Corporation |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4225 Executive Sq, La Jolla, California |
| Authorized Official Name and Position | Russell F Fuller (PRESIDENT, CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8585587707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fuller Psychology Corporation 4225 Executive Sq Suite 1110 La Jolla CA 92037-9122 Ph: (858) 558-7707 | Fuller Psychology Corporation 4225 Executive Sq Suite 1110 La Jolla CA 92037-9122 Ph: (858) 558-7707 |
| NPI Number | 1437325040 |
|---|---|
| Provider Enumeration Date | 05/03/2008 |
| Last Update Date | 05/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437325040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY16530 (California) | Primary |
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