Individual ProviderHaley FulkerMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address707 Idaho Ave Apt 308, Santa Monica, CA 90403-2877(650) 862-3090PECOS EnrollmentBased on the most recent information from CMS, provider Haley Fulker does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1548055320Provider TypeIndividualFull NameFulker, HaleyGenderFemaleSole ProprietorYesEnumeration Date4/11/2025Last Updated4/11/2025Contact InformationPractice LocationPractice Address707 Idaho Ave Apt 308, Santa Monica, CA 90403-2877Phone(650) 862-3090FaxUnlisted FaxMailing LocationMailing Address707 Idaho Ave Apt 308, Santa Monica, CA 90403-2877PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense147029California