Individual provider Active NPI

Mari Elizabeth Fullmer, M.A., LMFT

  • Marriage & Family Therapist
  • Santa Barbara, CA
National Provider Identifier
1700059664
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
83237 Issued in CA
Practice address
629 State Street, Suite 204
Santa Barbara, CA 93101
Phone
(805) 962-2963
Fax
(805) 962-2965
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 83237 CA Primary

Addresses

Primary practice location

629 State Street, Suite 204
Santa Barbara, CA 93101

Mailing address

629 State St, Suite 204
Santa Barbara, CA 93101-7071
Phone (805) 886-5707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 3, 2024 through Jan 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
83237CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1700059664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 STATE ST, SUITE 204",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931017071",
            "telephone_number": "805-886-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 STATE STREET, SUITE 204",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93101",
            "telephone_number": "805-962-2963",
            "fax_number": "805-962-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "MARI",
        "middle_name": "ELIZABETH",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.