Sharon Koenig Fuller, LCSW
Social Worker, Clinical in San Clemente, CA. Individual provider (NPI-1).
NPI number1962088906
StatusActive
Last updated in NPPESMar 21, 2021
Details
- NPI
- 1962088906
- Entity type
- Individual (NPI-1)
- Name
- Sharon Koenig Fuller
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 21, 2021
- Certification date
- Mar 19, 2021
- Last updated
- Mar 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | LCSW96024 | CA | Yes |
Practice location
64 Paseo RosaSan Clemente, CA 92673-6506
Phone 949-842-4413
Mailing address
64 Paseo RosaSan Clemente, CA 92673-6506
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