Individual
MORENA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2124 MAIN ST, HUNTINGTON BEACH, CA 92648-2405
(714) 536-0077
(714) 536-0071
Mailing address
2124 MAIN ST, HUNTINGTON BEACH, CA 92648-2405
(714) 536-0077
(714) 536-0071
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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