Active NPI
Amy Marie Fuller
- Behavior Analyst
- American Canyon, CA
National Provider Identifier
1013432343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-19551
- Practice address
- 120 Theresa Ave
American Canyon, CA 94503-9654 - Phone
- (707) 561-0922
- NPI assigned
- Aug 8, 2017
- Last updated
- Aug 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-15-19551 | CA | Primary |
Addresses
Primary practice location
120 Theresa Ave
American Canyon, CA 94503-9654
Mailing address
2409 Van Patter Dr
Santa Rosa, CA 95403-7695
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502150400000",
"number": "1013432343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2409 VAN PATTER DR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954037695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 THERESA AVE",
"city": "AMERICAN CANYON",
"state": "CA",
"postal_code": "945039654",
"telephone_number": "707-561-0922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "AMY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-08",
"last_updated": "2017-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-15-19551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in American Canyon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.