Amy Fuller

Key facts

NPI

1417323965

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

License

1-14-15992 (CA)

Practice address

2305 Arlington Ave S
Birmingham, AL 35205-4111

Phone

(205) 957-0294

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 10, 2022.

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1417323965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 ARLINGTON AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352054111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 ARLINGTON AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352054111",
            "telephone_number": "205-957-0294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2447 Pacific Coast Hwy",
            "address_purpose": "LOCATION",
            "city": "Hermosa Beach",
            "state": "CA",
            "postal_code": "902542714",
            "country_code": "US",
            "telephone_number": "310-374-3300 x251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-14-15992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Birmingham, AL · Behavior Analyst in Alabama