Individual
MRS. DESIREE L FULTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2495 W MARCH LN STE 125, STOCKTON, CA 95207-8224
(209) 465-1080
Mailing address
2495 W MARCH LN STE 125, STOCKTON, CA 95207-8224
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
CA
Other
Enumeration date
03/13/2008
Last updated
03/13/2008
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