Individual
LINA MICHELLE CARRILLO-FULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
308 EAST SAN JACINTO AVENUE, PERRIS, CA 92570
(951) 210-1349
Mailing address
4065 COUNTY CIRCLE DR, RIVERSIDE, CA 92503-3410
(951) 210-1349
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
257962
CA
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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