Fuller Psychology Corporation

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY16530 Issued in CA

Legal business name

FULLER PSYCHOLOGY CORPORATION

Practice address

4225 Executive SQ
Suite 1110
La Jolla, CA 92037-9122

Phone

(858) 558-7707

Fax

(858) 558-7708

NPI assigned

May 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Russell F Fuller, PSY.D.NPI 1912336413

Title

President, Clinical Psychologist

Phone

(858) 558-7707

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell F Fuller I, PSY.D.

  • Clinical Psychologist
  • La Jolla, CA
  • NPI 1912336413
  NPD (past) Authorized official

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

{
    "created_epoch": "1209772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209772800000",
    "number": "1437325040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ",
            "address_2": "SUITE 1110",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379122",
            "telephone_number": "858-558-7707",
            "fax_number": "858-558-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ",
            "address_2": "SUITE 1110",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379122",
            "telephone_number": "858-558-7707",
            "fax_number": "858-558-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-03",
        "last_updated": "2008-05-03",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT, CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "858-558-7707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navid Nicholas Froutan, MD
• Gina Reggiardo Frugoni, MD
• Jamie Fugett, DPT
• Casey Carol Retiro Fulinara, PA
• Lauren Fulkerson, M.D.
• Russell F Fuller I, PSY.D.
• William D. Fuller, M.D.
• Amy Funari, CRNP
• Linli Fung
• Jessica Lynne Funk, FNP-BC

• Clinical Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2008; 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.