Individual
BREANNA BIANCA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1486 HUNTINGTON AVE STE 100, SOUTH SAN FRANCISCO, CA 94080-5971
(650) 276-4101
Mailing address
1486 HUNTINGTON AVE STE 100, SOUTH SAN FRANCISCO, CA 94080-5971
(650) 276-4101
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2021
Last updated
09/06/2023
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