CAL STATE UNIVERSITY FULLERTON (NPI# 1013121961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013121961 |
| Entity Type | Organization |
| Organization Name | CAL STATE UNIVERSITY FULLERTON |
| Practice Address |
800 N State College Blvd Fullerton CA 92831-3547 |
| Practice Telephone | 7142782880 |
| Mailing Telephone | 7142782880 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. HOWARD WANG (DIRECTOR) |
| Authorized Official Telephone | 7142782821 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
244163 | CA | Ambulatory Health Care Facilities |
| Street Address |
800 N STATE COLLEGE BLVD |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-3547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083641013 | Tricia Mikiko Kasamatsu | Specialist/Technologist | 800 N State College Blvd, Attn: Kinesiology, Fullerton, CA 92831-3547 | 2006-06-26 |
| 1720551237 | Merrisa Carlson | Nurse Practitioner | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2019-01-08 |
| 1538639919 | Anna Marie Peery | Midwife | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2018-11-28 |
| 1558860221 | Samuel Arnold | Specialist/Technologist | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2018-02-07 |
| 1013415967 | Andee Monterone | Student in an Organized Health Care Education/Training Program | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2018-01-25 |
| 1184132615 | Kevin Benjamin Perez | Counselor | 800 N State College Blvd, Fullerton, CA 92831-3599 | 2018-01-18 |
| 1487161147 | Holly Vigario | Specialist/Technologist | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2018-01-03 |
| 1992211403 | Juan Carlos Madrigal | Specialist/Technologist | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2017-12-19 |
| 1134655178 | Elena Soler | Specialist/Technologist | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2017-05-11 |
| 1982130415 | Jaime Potter | Specialist/Technologist | 800 N State College Blvd, Fullerton, CA 92831-3547 | 2017-05-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356807226 | Barba Dds Inc | Clinic/Center | 118 N State College Blvd Ste A, Fullerton, CA 92831-4215 | 2019-02-15 |
| 1760684526 | Test-med Vaccination Services Medical Corp | Clinic/Center | 140 E Santa Fe Ave, Fullerton, CA 92832-1916 | 2007-06-04 |
| 1790071454 | Bethel O & A, Incorporated | Clinic/Center | 285 S Gilbert St, Fullerton, CA 92833-2908 | 2011-06-21 |
| 1699962175 | Regina Lee Williams | Clinic/Center | 140 E Santa Fe Ave, Fullerton, CA 92832-1916 | 2007-09-28 |
| 1518987403 | James Irving Honda | Clinic/Center | 1321 N Harbor Blvd, Ste 202, Fullerton, CA 92835-4124 | 2006-07-20 |
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| 1316557358 | Breathe Thermae, Inc. | Clinic/Center | 200 S Cahuilla Rd, Palm Springs, CA 92262-6334 | 2020-08-04 |
| 1497363212 | Joana Anjeh Tala | Clinic/Center | 2951 Hampshire Cir, Corona, CA 92879-6133 | 2020-07-17 |
| 1376160580 | Beyond Practice, Inc. | Clinic/Center | 300 W Ocean Blvd Apt 6114, Long Beach, CA 90802-8029 | 2020-07-03 |
| 1205452315 | Affection Healthcare LLC | Clinic/Center | 1641 North Ripon Road, Ripon, CA 95366 | 2020-06-24 |
| 1467074963 | Onclick Healthcare Incorporated | Clinic/Center | 2625 Townsgate Rd Ste 330, Westlake Village, CA 91361-5749 | 2020-05-07 |
| 1811517832 | D.e. Garrison, D.o., Inc. | Clinic/Center | 3209 Esplanade Ste 120, Chico, CA 95973-0154 | 2020-04-20 |
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| 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.