Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE FULLER
ActiveSHANE FULLER is a Addiction (Substance Use Disorder) Counselor healthcare provider located in WILTON, California. NPI 1497112114 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · WILTON, CA
Registration Details
- NPI Number
- 1497112114
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 26, 2016 (10.563406071204 yrs)
- Last Updated
- Jan 26, 2016
Practice Information
- Address
-
11255 MANN RDWILTON, CA, 956939712Browse CA providers · Browse ZIP 95693
- Phone
- 9166060027
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.