person
Shane Fuller
Addiction (Substance Use Disorder) Counselor in Wilton, California
NPI 1497112114

Shane Fuller is an Addiction (Substance Use Disorder) Counselor based in Wilton, CA and is specialized in Addiction (Substance Use Disorder). Shane Fuller practices in Wilton, CA. The NPI Number for Shane Fuller is 1497112114 and holds a License No. (California).

The current practice location address for Shane Fuller is 11255 Mann Rd, Wilton, CA and can be reached out via phone at 916-606-0027.

Location: 11255 Mann Rd, Wilton, CA, 95693-9712
person
Provider Profile Details
NPI Number
1497112114
Provider Name
Shane Fuller
Credential
Provider Entity Type
Individual
Gender
Male
Address
11255 Mann Rd, Wilton, CA, 95693-9712
Phone Number
916-606-0027
Fax Number
Provider Enumeration Date
01/26/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11255 Mann Rd
City
State
Zip
95693-9712
Phone Number
916-606-0027
Fax Number
person
Provider Business Mailing Address Details
Address
11255 Mann Rd
City
State
Zip
95693-9712
Phone Number
916-606-0027
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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