person
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. You can also correspond with Latasha Fuller through the mailing address at 31764 CASINO DR, LAKE ELSINORE, CA - 92530-2312 (mailing address contact number: ).

Location: 31764 Casino Dr, Lake Elsinore, CA, 92530-2312
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
State
Zip
92530-2312
Phone Number
951-471-4645
Fax Number
person
Provider Business Mailing Address Details
Address
31764 Casino Dr
City
State
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
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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