Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. La Crystal L. Fuller, RNP, RNFA

Individual provider Nurse Practitioner · NPI 1093894594

MS. La Crystal L. Fuller, RNP, RNFA is a Nurse Practitioner in Fullerton, California. Qualified in 2004, 22 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
22
Licensed in
CA
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

1950 Sunny Crest Dr Ste 2800 Medical Center For Women
Fullerton, CA 92835-3638
Phone: (714) 992-5350
Fax: (714) 992-8156
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 14784 (CA)
Nurse Practitioner Taxonomy 363L00000X · Licence 14784 (CA)

Record details

NPI number1093894594
Entity typeIndividual (Type 1)
GenderFemale
Credentials RNP , RNFA
Sole proprietorNo
NPI enumeratedNovember 3, 2006
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Fullerton