Imani S Fuller

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1480 Paseo Verde Pkwy Apt 3211
Henderson, NV 89012-6510

Phone

(323) 793-3875

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1093447385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 PASEO VERDE PKWY APT 3211",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890126510",
            "telephone_number": "323-793-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 PASEO VERDE PKWY APT 3211",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890126510",
            "telephone_number": "323-793-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "IMANI",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Fuentes
• Mariah Fuentes
• Iliana Esther Fuentez Osuna
• Ivana P. Fukumoto, NP-C
• Full Function Physical Therapy, LLC
• Kaylee Arline Fuller
• Peter Fuller, M.D.
• Staci Fuller
• Josephine Fulton
• Margie Noda Funcion

• Behavior Technician in Henderson, NV
• Providers in Henderson, NV by specialty
• Behavior Technician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.