KELLY ANNE FULLER (NPI# 1861964553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861964553 |
| Entity Type | Individual |
| Full Name | KELLY ANNE FULLER |
| Practice Address |
850 E Foothill Blvd Rialto CA 92376-5230 |
| Practice Telephone | 9095802866 |
| Mailing Telephone | 9095802866 |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 100457 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144793407 | Kelly Fuller | Nurse Practitioner | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2019-01-09 |
| 1871614115 | Kelly Sue Fuller | Counselor | 1811 Sardis Rd N, Suite 207, Charlotte, NC 28270-1426 | 2007-04-03 |
| Street Address |
850 E FOOTHILL BLVD |
| City | RIALTO |
| State | CA |
| Zip Code | 92376-5230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366420317 | Calvin Flowers, Md, Inc. | Psychiatry & Neurology | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2006-01-09 |
| 1306461314 | Danny Contreras | Peer Specialist | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-06-15 |
| 1568087674 | David Lindstrom | Registered Nurse | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-06-15 |
| 1932724721 | Sintia Michelle Diaz | Peer Specialist | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-06-08 |
| 1184245557 | Alma Delia Gonzalez | Marriage & Family Therapist | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-04-27 |
| 1649801044 | Vera Prado Perry | Counselor | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-02-04 |
| 1083245567 | Michelle Ellis | Case Manager/Care Coordinator | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-02-03 |
| 1396375143 | Lisa Nicole Ramos | Case Manager/Care Coordinator | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-01-21 |
| 1215574538 | Diane Valdivia | Case Manager/Care Coordinator | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2019-12-05 |
| 1508402371 | Tisha Jenyo | Licensed Psychiatric Technician | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2019-11-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780141812 | Sochun Operation, Inc. | Assisted Living Facility | 1441 S. Riverside Ave., Rialto, CA 92376 | 2019-02-25 |
| 1487138244 | National Vision Inc | Technician/Technologist | 1175 Renaissance Parkway, Suite 1050, Rialto, CA 92376 | 2018-09-18 |
| 1942780853 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 1205 W Renaissance Pkwy, Suite 240, Rialto, CA 92376 | 2018-08-20 |
| 1114430238 | Li Watkins | Nurse Practitioner | 280 N Riverside Avenue, Rialto, CA 92376 | 2017-11-10 |
| 1346767837 | Imelda Jazmin Ceja Nunez | Behavioral Analyst | 462 E Wilson St, Rialto, CA 92376 | 2017-08-24 |
| 1720505662 | Taylor Sandoval | Behavioral Analyst | 2935 Cardamon St, Rialto, CA 92376 | 2017-08-22 |
| 1427572510 | Danielle Mccree | Physical Therapy Assistant | 1470 N Filmore Ave, Rialto, CA 92376 | 2017-07-31 |
| 1639699952 | Albert Anthony Torres | Specialist/Technologist | 1008 N. Pampas Ave., Rialto, CA 92376 | 2017-06-27 |
| 1124407358 | Miesha Warren | Peer Specialist | 850 East Foothill Bld, Rialto, CA 92376 | 2015-05-20 |
| 1205233483 | Albert Archuleta | Counselor | 1501 Riverside Ave, Rialto, CA 92376 | 2014-12-03 |
| Find all providers in zip 92376 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285081208 | Robert Sega | Marriage & Family Therapist | 1740 N Verde Ave, Rialto, CA 92376-2750 | 2016-05-19 |
| 1336556026 | Deandra Edison-riley | Marriage & Family Therapist | 2765 W Loma Vista Dr, Rialto, CA 92377-3445 | 2014-07-15 |
| 1043638752 | Luisa Limon | Marriage & Family Therapist | 850 E. Foothill Ave., Rialto, CA 92376 | 2014-03-31 |
| 1427273143 | Sue Ellen Christian | Marriage & Family Therapist | 603 S Millard Ave, Rialto, CA 92376 | 2007-04-16 |
| 1073647053 | Annette Allen Jenkins | Marriage & Family Therapist | 229 S Riverside Ave, Suite M, Rialto, CA 92376-6467 | 2007-03-14 |
| 1669513768 | Maria Luz Coronado | Marriage & Family Therapist | 850 E. Foothill Boulevard, Rialto, CA 92376 | 2007-02-09 |
| 1780720557 | Jane C Smith | Marriage & Family Therapist | 850 E Foothill Blvd Ste D, Rialto, CA 92376-5230 | 2007-01-29 |
| 1184245557 | Alma Delia Gonzalez | Marriage & Family Therapist | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2020-04-27 |
| 1649759135 | Andrew David Gonzalez | Marriage & Family Therapist | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2018-08-07 |
| 1366928525 | Tiffanay Michelle Perry | Marriage & Family Therapist | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2018-07-11 |
| Find all providers in RIALTO | ||||
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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.