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NPI Code Detail

MEDICARE: MS. VILDANA KAPIDZIC FULTON M.A.

MEDICARE: MS. VILDANA KAPIDZIC FULTON M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC27884CA

General Provider Information

NPI Number : 1235242660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VILDANA KAPIDZIC FULTON M.A.
Provider Business Mailing Address
First Line : 7806 UPLANDS WAY
Second Line : SUITE A
City : CITRUS HEIGHTS
State : CA
Zip : 95610-7567
Country : US
Telephone Number : 916-967-6253
Fax Number :
Provider Business Practice Location Address
First Line : 7806 UPLANDS WAY
Second Line : SUITE A
City : CITRUS HEIGHTS
State : CA
Zip : 95610-7567
Country : US
Telephone Number : 916-967-6253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 01/06/2011

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