Tierra Fuller
Rehabilitation Practitioner in View Park, CA. Individual provider (NPI-1).
NPI number1669946372
StatusActive
Last updated in NPPESJun 12, 2019
Details
- NPI
- 1669946372
- Entity type
- Individual (NPI-1)
- Name
- Tierra Fuller
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 15, 2019
- Last updated
- Jun 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
5300 Angeles Vista BlvdView Park, CA 90043
Phone 323-295-4555
Mailing address
5300 Angeles Vista BlvdView Park, CA 90043-1648
Phone 323-295-4555
Other practice locations
5201 S Vermont Ave
Los Angeles, CA 90037-3527
Los Angeles, CA 90037-3527
Phone 323-751-3026
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All 49 Rehabilitation Practitioner providers in View Park · All 225 providers in View Park
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