Provider Demographics
NPI:1245413061
Name:FULKERSON, ERIN E
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:E
Last Name:FULKERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9261 FOLSOM BLVD
Mailing Address - Street 2:500
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2561
Mailing Address - Country:US
Mailing Address - Phone:916-363-1553
Mailing Address - Fax:916-363-1565
Practice Address - Street 1:9261 FOLSOM BLVD
Practice Address - Street 2:500
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2561
Practice Address - Country:US
Practice Address - Phone:916-363-1553
Practice Address - Fax:916-363-1565
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor