Healthcare Provider Details

I. General information

NPI: 1801809058
Provider Name (Legal Business Name): DOROTHY JANE FULLER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 E ALISAL ST SUITE 201
SALINAS CA
93905-2516
US

IV. Provider business mailing address

559 E ALISAL ST SUITE 201
SALINAS CA
93905-2516
US

V. Phone/Fax

Practice location:
  • Phone: 831-769-8800
  • Fax: 831-422-9312
Mailing address:
  • Phone: 831-769-8800
  • Fax: 831-422-9312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number135163
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number312
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: