Fuller Theological Seminary

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FULLER THEOLOGICAL SEMINARY

Doing business as

Fuller Psychological and Family Services

Practice address

180 North Oakland Avenue
Pasadena, CA 91101-1714

Phone

(626) 584-5555

Fax

(626) 584-5558

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Theopolis Cosse, PSYD, MBA

Title

Executive Director

Phone

(626) 584-5566

Specialties & licenses 9

Addresses

Other names 1

• Fuller Psychological and Family Services Doing business as

Tax ID family

Fuller Psychological and Family Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fuller Theological Seminary

  • Marriage & Family Therapist
  • Phoenix, AZ
  • NPI 1831979087
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Fuller Psychological and Family Services

  • Student in an Organized Health Care Education/Training Program
  • Pasadena, CA
  • NPI 1801374772
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ted Cosse, M.A.

  • Psychologist
  • Pasadena, CA
  • NPI 1447480868
  NPD
• Rachel Lingle, LMFT

  • Marriage & Family Therapist
  • Chandler, AZ
  • NPI 1164921409
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1013126036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NORTH OAKLAND AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91101",
            "telephone_number": "626-584-5555",
            "fax_number": "626-584-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NORTH OAKLAND AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011714",
            "telephone_number": "626-584-5555",
            "fax_number": "626-584-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER THEOLOGICAL SEMINARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "COSSE",
        "authorized_official_first_name": "THEOPOLIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-584-5566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PSYD, MBA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuller Psychological and Family Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fuller Psychological and Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andei Fukushige, APCC
• Rachel M. Fulginiti, B.A.
• Full Motion Physical Therapy Services Inc
• Fuller Acupuncture Clinic
• Fuller Psychological and Family Services
• Catherine Grace Fuller, PH.D.
• Hannah M Fuller, DPT
• Julie Anne Fullmore
• Akira Funahashi, OTR/L, OTD
• Bert K. Funatsu, D.D.S.

• Community/Behavioral Health Agency in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.