Organization
SIGNATURE MINDCARE NURSING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LA CRYSTAL FULLER NP (CEO)
(562) 522-3457
Entity
Organization
Contact information
Practice address
2283 WALTONIA DR, MONTROSE, CA 91020-1261
(323) 849-3309
Mailing address
2029 VERDUGO BLVD # 326, MONTROSE, CA 91020-1626
(323) 849-3309
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
10/22/2024
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