Individual provider Active NPI

Laura Dyann Tully, M.D.

  • Psychiatry Physician
  • San Francisco, CA
National Provider Identifier
1710272687
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A122643 Issued in CA
Practice address
490 Post St Ste 1043
San Francisco, CA 94102-1301
Phone
(925) 282-1778
NPI assigned
Jun 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A122643 CA Primary

Addresses

Primary practice location

490 Post St Ste 1043
San Francisco, CA 94102-1301

Mailing address

490 Post St Ste 1043
San Francisco, CA 94102-1301
Phone (925) 282-1778

Other practice location 1

1720 El Camino Real Ste 140
Burlingame, CA 94010-3231
Phone (925) 282-1778

Other practice location 2

350 Sansome St Ste 630
San Francisco, CA 94104-1311
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121119000314 CA Practitioner - Psychiatry 3173774221 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Psychiatry CurrentSince Jul 8, 2025 Accepting new patients

Locations

1720 El Camino Real
Ste 140
Burlingame, CA 94010

1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

350 Sansome St
Ste 630
San Francisco, CA 94104
Phone (415) 317-6991

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.lauratully@148377.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1308355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1710272687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 POST ST STE 1043",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021301",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 POST ST STE 1043",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021301",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 El Camino Real Ste 140",
            "address_purpose": "LOCATION",
            "city": "Burlingame",
            "state": "CA",
            "postal_code": "940103231",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Sansome St Ste 630",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941041311",
            "country_code": "US",
            "telephone_number": "925-282-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLY",
        "first_name": "LAURA",
        "middle_name": "DYANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-18",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A122643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.