Dalia Dauod Fullingim, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF 87649 Issued in CA

Practice address

11731 Telegraph Rd
Santa Fe Springs, CA 90670-3675

Phone

(714) 724-6320

NPI assigned

Apr 1, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: daliafullingim@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1003279548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ARTESIA BLVD",
            "address_2": "APT 18",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907068953",
            "telephone_number": "714-724-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11731 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703675",
            "telephone_number": "714-724-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLINGIM",
        "first_name": "DALIA",
        "middle_name": "DAUOD",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF 87649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Marie Frias, MFT TRAINEE
• Lucero Frias
• Carrie Renee Frost
• Frank Fuentes
• Vanesa Fuentes
• Victoria Angela Gabat
• Carolina Gabriel
• Karen Gaeta
• Karina Galdamez
• Bryan Galeas

• Mental Health Counselor in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.