Sara Ajifu - Tully, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80892 Issued in CA

Practice address

17100 Euclid St
Fountain Valley, CA 92708-4004

Phone

(714) 966-8171

NPI assigned

Feb 16, 2018

Sex

Female

Sole proprietor

No

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD CA
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1952333460
  NPD

• Sara Ajifu Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 25, 2021.

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1124528104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11170 WARNER AVE STE 206",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084014",
            "telephone_number": "714-966-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084004",
            "telephone_number": "714-966-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJIFU - TULLY",
        "first_name": "SARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "AJIFU",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zavier Shawkat Ahmed, M.D.
• Amy Ahn, OTR/L
• Ai Huang, D.M.D., Inc.
• Nicholas Aiello, MSW, LSW
• Ajay Bhatnagar MD PC
• Kimberly Akamine, M.S.
• Lori Akasaka, LCSW
• Shiva Akhavan, HIS
• Maria Akhnoukh
• Deema Omar Al-Omar

• All providers in Fountain Valley, CA
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.