Individual provider Active NPI

Juliana Noel Fuller, NP

  • Family Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1265788087
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 83206 Issued in CA
Practice address
25455 Barton Rd
Loma Linda, CA 92354-3128
Phone
(909) 558-6600
NPI assigned
Jul 30, 2012
Last updated
Jul 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 83206 CA Primary

Addresses

Primary practice location

25455 Barton Rd
Loma Linda, CA 92354-3128

Mailing address

File # 54701
Los Angeles, CA 90074-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120917000232 CA Practitioner - Nurse Practitioner 0042468092 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
730191CAMDLicensed Vocational Nurse
NP 83206CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 22, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients

Locations

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: jfuller7000@direct.llu.edu

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1265788087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE # 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543128",
            "telephone_number": "909-558-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JULIANA",
        "middle_name": "NOEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 83206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.