DR. FERNANDO ULLOA (NPI# 1124140686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124140686 |
| Entity Type | Individual |
| Full Name | DR. FERNANDO ULLOA |
| Credential | M.D. |
| Practice Address |
711 D St Suite 113 San Rafael CA 94901-3707 |
| Mailing Address |
Po Box 1938 Mill Valley CA 94942-1938 |
| Practice Telephone | 4154544100 |
| Mailing Telephone | 4154544100 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
G49903 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G49903 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043459563 | Fernando M Ulloa | Registered Nurse | 5607 31st Ave Apt 6h, Woodside, NY 11377-1508 | 2009-02-05 |
| Street Address |
711 D ST SUITE 113 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326018441 | Howard Scott Ortman | Podiatrist | 711 D St, Suite 114, San Rafael, CA 94901-3707 | 2006-01-23 |
| 1528383494 | Virginia Gail Johnson | Marriage & Family Therapist | 711 D St, #211, San Rafael, CA 94901-3707 | 2010-04-02 |
| 1669703542 | Tom Thurston | Marriage & Family Therapist | 711 D St, Suite 201, San Rafael, CA 94901-3707 | 2010-01-17 |
| 1114193711 | Linda Silver | Counselor | 711 D St, #201, San Rafael, CA 94901-3707 | 2008-05-02 |
| 1548440209 | Shannon D Myers | Marriage & Family Therapist | 711 D St, Suite 201, San Rafael, CA 94901-3707 | 2007-11-10 |
| 1457530164 | Michael Sedaghatfar | Dentist | 711 D St, Suite 107, San Rafael, CA 94901-3707 | 2007-10-30 |
| 1447439153 | Mary Rachel Brinker | Dentist | 711 D St, Suite 107, San Rafael, CA 94901-3707 | 2007-10-30 |
| 1871712240 | Friedman Chiropractic Inc | Chiropractor | 711 D St, Suite 104, San Rafael, CA 94901-3703 | 2007-04-24 |
| 1083833420 | Jeffrey I Friedman | Chiropractor | 711 D St, Suite 104, San Rafael, CA 94901-3703 | 2007-04-24 |
| 1821214941 | Kirk Allen Rockwell | Chiropractor | 711 D St, Suite 115, San Rafael, CA 94901-3707 | 2007-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154986107 | School Health Clinics of Santa Clara County | Pediatrics | 855 Lenzen Ave Rm 105, San Jose, CA 95126-2736 | 2019-05-06 |
| 1669927125 | Irvine Doctors of Kids and Teens | Pediatrics | 4950 Barranca Pkwy Ste 306, Irvine, CA 92604-4631 | 2016-08-24 |
| 1043673270 | Alexander S Golec | Pediatrics | 3333 California St Ste 245, San Francisco, CA 94118-6210 | 2016-04-04 |
| 1710360094 | Jennifer Johnson, M.d., A Professional Corporation | Pediatrics | 366 San Miguel Dr Ste 209, Newport Beach, CA 92660-7810 | 2015-07-03 |
| 1902290448 | Brittany Kathleen Badal | Pediatrics | 2330 Post St Ste 219, San Francisco, CA 94115-3465 | 2015-03-23 |
| 1750770608 | Ighia Aintablian Md A Professional Corporation | Pediatrics | 1510 S Central Ave Ste 450, Glendale, CA 91204-2510 | 2015-01-15 |
| 1184035032 | Carlos Beharie M.d. Medical Group, Inc. | Pediatrics | 4160 N. Maine Ave, Suite B1, B2, B3, Baldwin Park, CA 91706-3304 | 2014-05-14 |
| 1164859385 | Pediatric Adolescent Clinic | Pediatrics | 1214 Adriana Way, Upland, CA 91784-1742 | 2013-10-02 |
| 1578804084 | Eleanor S. Blatt | Pediatrics | 212 20th St, Huntington Beach, CA 92648-3914 | 2013-03-07 |
| 1053676619 | Gladys Hope Dadivas Yerro | Pediatrics | 14555 Hamlin St Ste 108, Van Nuys, CA 91411-1617 | 2012-07-10 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
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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.