Individual
BRIANNE FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2640 BRESLAUER WAY, REDDING, CA 96001-4246
(530) 225-5252
Mailing address
2640 BRESLAUER WAY, REDDING, CA 96001-4246
(530) 225-5252
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPCC4041
CA
101YP2500X
Professional Counselor
Primary
LPCC4041
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y4420942
DRIVER'S LICENSE
CA
Enumeration date
07/16/2013
Last updated
01/21/2021
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