LATASHA FULLER NPI 1184330193

NPI Information

  • NPI: 1184330193
  • Provider Name: LATASHA FULLER
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Individual
  • Address: 31764 CASINO DR
    LAKE ELSINORE, CA
    ZIP 92530
  • Phone: (951) 471-4645

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NPI Details

Latasha Fuller is an adult mental health clinic center in Lake Elsinore, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. Latasha Fuller NPI is 1184330193. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

31764 CASINO DR
LAKE ELSINORE, CA
ZIP 92530-312
Phone: (951) 471-4645

The enumeration date for this NPI number is 1/24/2023 and was last updated on 1/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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