Individual
MELODY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
655 MENLO DR, ROCKLIN, CA 95765-3718
(916) 740-1620
Mailing address
11230 GOLD EXPRESS DR # 310-119, GOLD RIVER, CA 95670-4484
(916) 952-0901
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
119209
CA
1041S0200X
School Social Worker
Primary
240225121
CA
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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