Cheryl C. Fuller PHD PA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2-3404 Issued in TX

Legal business name

CHERYL C. FULLER PHD PA

Practice address

1814 8TH Ave # B
Fort Worth, TX 76110-1354

Phone

(817) 735-8222

Fax

(817) 924-1369

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Cheryl C. Fuller, PHD

Title

President

Phone

(817) 735-8222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Peter Craig Kowalski, MD

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1639107444
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1689789901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 BELLAIRE DR S APT 226W",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761095197",
            "telephone_number": "817-735-8222",
            "fax_number": "817-924-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 8TH AVE # B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101354",
            "telephone_number": "817-735-8222",
            "fax_number": "817-924-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERYL C. FULLER PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-735-8222",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "2-3404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0012JC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Cherry
• Kylie R Cherry, CPNP
• Paul Cherry, LPC, LCDC
• Kelly Marie Cherryhomes Cox, CCLS
• Sheva Khorrami Chervinskiy, DO
• Debbie Denise Chesney, RPH
• Jessica Chesnut
• Jennifer Anne Chester, LCSW
• Jee Eun Naomi Chew, DDS
• CHH Home Health, LLC

• Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.