Provider Demographics
NPI:1548408834
Name:PULLEN, DOLORES SANCHEZ (MFCT)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:SANCHEZ
Last Name:PULLEN
Suffix:
Gender:F
Credentials:MFCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 ROSECRANS STREET
Mailing Address - Street 2:SUITE I
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1360 ROSECRANS STREET
Practice Address - Street 2:SUITE I
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106
Practice Address - Country:US
Practice Address - Phone:619-224-2216
Practice Address - Fax:619-224-2215
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22423101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor