Qynncie Alexandria Fuller, BA
Student in an Organized Health Care Education/Training Program in Riverside, CA. Individual provider (NPI-1).
Details
- NPI
- 1164021416
- Entity type
- Individual (NPI-1)
- Name
- Qynncie Alexandria Fuller
- Credential
- BA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 19, 2020
- Certification date
- May 1, 2025
- Last updated
- May 1, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | CA | Yes |
Practice location
2085 Rustin AveRiverside, CA 92507-2498
Phone 951-955-7334
Mailing address
1280 Paseo Azul WayCorona, CA 92879-8502
Phone 951-840-7958
Other practice locations
Costa Mesa, CA 92626-4650
Phone 714-881-0427 · Fax 714-327-0673
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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