Individual
TRACEY FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 W CAMPBELL AVE, SUITE 201, CAMPBELL, CA 95008-1526
(408) 871-4900
Mailing address
1600 W CAMPBELL AVE, SUITE 201, CAMPBELL, CA 95008-1526
(408) 871-4900
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CA
171M00000X
Case Manager/Care Coordinator
—
CA
Other
Enumeration date
02/06/2017
Last updated
05/04/2017
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