SONYA FULGHAM


Address: 1643 92nd Street, #c, Los Angeles, CA 90002
Phone: 3234904550

SONYA FULGHAM (NPI# 1588028708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588028708
Entity Type Individual
Full Name SONYA FULGHAM
Credential MFT
Practice Address 1643 92nd Street
#c
Los Angeles
CA 90002
Mailing Address 1643 E. 92nd Street
#c
Los Angeles
CA 90002
Practice Telephone 3234904550
Mailing Telephone 6262584311
Enumeration Date 2016-04-13
Last Update Date 2016-04-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
6949-R CA Behavioral Health & Social Service Providers

Office Location

Street Address 1643 92ND STREET
#C
City LOS ANGELES
State CA
Zip Code 90002

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City LOS ANGELES
Zip Code 90002

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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