Individual
AJAYA L FULLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 TUPELO DR, CITRUS HEIGHTS, CA 95621-1741
(916) 729-3098
Mailing address
6649 SUNRISE BLVD APT 8, CITRUS HEIGHTS, CA 95610-4559
(415) 548-3508
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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