Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER CARROLL FULLER
ActiveJENNIFER CARROLL FULLER is a Facial Plastic Surgery healthcare provider located in LOMA LINDA, California. NPI 1902149933 is currently active in the NPPES registry. Verify at CMS.
Facial Plastic Surgery · LOMA LINDA, CA
Registration Details
- NPI Number
- 1902149933
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 27, 2013 (13.34540964825 yrs)
- Last Updated
- Jul 10, 2019
- Licenses
-
63479 (MN)A160366 (CA)
Practice Information
- Address
-
11234 ANDERSON ST # 2586ALOMA LINDA, CA, 923542804Browse CA providers · Browse ZIP 92354
- Phone
- 9095587884
- Primary Specialty
-
Facial Plastic Surgery
207YX0905X
- Additional Specialty
- Facial Plastic Surgery
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.