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Individual
DR. TRAVIS DAUNTIA FULTZ
Active
Individual
DR. TRAVIS DAUNTIA FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 19419
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY 194190
—
CA
Enumeration date
11/18/2005
Last updated
07/08/2007
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