Individual
PAIGE DANIELLE FULMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
1551 BISHOP ST STE 520, SAN LUIS OBISPO, CA 93401-4665
(415) 756-1799
Mailing address
1551 BISHOP ST STE 520, SAN LUIS OBISPO, CA 93401-4665
(805) 461-5212
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42853
CA
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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