Provider Demographics
NPI:1639982077
Name:BULLER, ERICA ANNE (MS, PPA)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANNE
Last Name:BULLER
Suffix:
Gender:F
Credentials:MS, PPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 E KERCKHOFF AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-2709
Mailing Address - Country:US
Mailing Address - Phone:402-525-1612
Mailing Address - Fax:
Practice Address - Street 1:658 E ADAMS AVE
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:CA
Practice Address - Zip Code:93625-2198
Practice Address - Country:US
Practice Address - Phone:402-525-1612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool