Rulon Fullmer, MFT STUDENT INTERN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

791 N Pepper Ave
Colton, CA 92324-1800

Phone

(190) 982-4048

NPI assigned

Jun 8, 2012

Last updated

Jun 8, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• LDS Family Services

  dba LDS Family Services CA Colton

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colton, CA
  • NPI 1386765345
  NPD (past)

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1508128265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 COLLEGE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241800",
            "telephone_number": "190-982-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "RULON",
        "credential": "MFT STUDENT INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT STUDENT INTERN",
            "identifier": "390200000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wade Garret Fueconcillo
• Kristina Anne Fuertez
• Guay Khim Fugate, RN1953
• Tomara Fuller
• Rhonda Fullmer
• Lloyd Charles Furness
• G & C Swan Inc (New Creation)
• G & C Swan Inc
• Alexandra Celino Gacuya, MD
• Alkevin Gacuya

• Marriage & Family Therapist in Colton, CA
• Providers in Colton, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.