Individual provider Active NPI

Jezzie Fulmen, MFT INTERN

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1730390188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF 44550 Issued in CA
Practice address
103 Hayes St.
San Francisco, CA 94102
Phone
(415) 626-7000
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IMF 44550 CA Primary

Addresses

Primary practice location

103 Hayes St.
San Francisco, CA 94102

Mailing address

1390 Market St
Suite 800
San Francisco, CA 94102-5402
Phone (415) 626-7000

Other names 1

  • Christina Fulmen Professional name

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

LicenseStateTypeSpecialty
IMF 44550CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730390188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 MARKET ST",
            "address_2": "SUITE 800",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025402",
            "telephone_number": "415-626-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 HAYES ST.",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94102",
            "telephone_number": "415-626-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMEN",
        "first_name": "JEZZIE",
        "credential": "MFT INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 44550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "FULMEN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.