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Individual

MS. KRISTIN MARIE LULICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, PMHNP-BC

Contact information

Practice address
4510 EXECUTIVE DR, #115, SAN DIEGO, CA 92121-3021
(619) 383-6700
Mailing address
4510 EXECUTIVE DR, #115, SAN DIEGO, CA 92121-3021
(619) 383-6700

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
795367
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95002702
CA

Other

Enumeration date
03/08/2012
Last updated
12/01/2016
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