Active NPI
Deborah Jeanne Tully, P.T.
- Physical Therapist
- San Anselmo, CA
National Provider Identifier
1528504396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 18132
- Practice address
- 21 Belle Ave Apt 5
San Anselmo, CA 94960-2826 - Phone
- (707) 349-2028
- NPI assigned
- Jan 17, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 18132 | CA | Primary |
Addresses
Primary practice location
21 Belle Ave Apt 5
San Anselmo, CA 94960-2826
Mailing address
250 Bon Air Rd
Physical Therapy Dept
Greenbrae, CA 94904-1702
Phone (415) 925-7821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 18132 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1528504396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BON AIR RD",
"address_2": "PHYSICAL THERAPY DEPT",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949041702",
"telephone_number": "415-925-7821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 BELLE AVE APT 5",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949602826",
"telephone_number": "707-349-2028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "DEBORAH",
"middle_name": "JEANNE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-17",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 18132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Anselmo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.