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Latasha Fuller
Adult Mental Health Clinic/Center in Lake Elsinore, California
NPI 1184330193

Latasha Fuller is an Adult Mental Health Clinic/Center based in Lake Elsinore, CA and is specialized in Adult Mental Health. Latasha Fuller practices in Lake Elsinore, CA. The NPI Number for Latasha Fuller is 1184330193 and holds a License No. (California).

The current practice location address for Latasha Fuller is 31764 Casino Dr, Lake Elsinore, CA and can be reached out via phone at 951-471-4645.

Location: 31764 Casino Dr, Lake Elsinore, CA, 92530-2312
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184330193
Provider Name
Latasha Fuller
Credential
Provider Entity Type
Individual
Gender
Female
Address
31764 Casino Dr, Lake Elsinore, CA, 92530-2312
Phone Number
951-471-4645
Fax Number
Provider Enumeration Date
01/24/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
31764 Casino Dr
City
Lake Elsinore
State
California
Zip
92530-2312
Phone Number
951-471-4645
Fax Number
person
Provider Business Mailing Address Details
Address
31764 Casino Dr
City
Lake Elsinore
State
California
Zip
92530-2312
Phone Number
951-471-4645
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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