| Doctor Name: | DALIA DAUOD FULLINGIM |
| NPI Number: | 1003279548 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | IMF 87649 |
| Business Practice Address: | 11731 Telegraph Rd Santa Fe Springs, CA - 906703675 |
| Business Phone Number: | 7147246320 |
| Business Fax Number: | |
| Mailing Address: | 9301 Artesia Blvd, Apt 18 BELLFLOWER |
| State: | CA |
| Postal Code: | 907068953 |
| Phone Number: | 7147246320 |
| Fax Number: | |
| NPI Enumeration Date: | 04/01/2016 |
| NPI Last Update Date: | 06/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMF 87649 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |