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General NPI Number Information
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NPI Number | 1598771446
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Entity Type | Individual
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Provider Name | ANN CORBIN-FULCHIRON LCSW, CADC-II
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 8810 RIO SAN DIEGO DR STE 2121
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City | SAN DIEGO
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State | CA
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Zip | 92108-1698
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Country | US
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Telephone | 619-400-5271
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 211813
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City | CHULA VISTA
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State | CA
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Zip | 91921-1813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A8486204
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 23046
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License Number State | CA
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