Laurel Jill Mullally, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

410836 Issued in CA

Practice address

5130 Riverside Dr
Chino, CA 91710-4130

Phone

(909) 628-1201

Fax

(909) 062-8671

NPI assigned

Apr 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Chino Unified School District

  • Local Education Agency (LEA)
  • Chino, CA
  • NPI 1144363946
  NPD (past)
• Chino Valley Unified School District Behavioral Health Center

  dba CVUSD Behavioral Health Center

  • Community/Behavioral Health Agency
  • Chino, CA
  • NPI 1043522543
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750500104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 CAMINO DEL SOL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331321",
            "telephone_number": "909-628-1201",
            "fax_number": "909-628-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 RIVERSIDE DR",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917104130",
            "telephone_number": "909-628-1201",
            "fax_number": "909-062-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLALLY",
        "first_name": "LAUREL",
        "middle_name": "JILL",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "410836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Morris, O.D.
• Amber Beth Moryl, MS, MPAS, PA-C
• MP Medical Services, Inc (Alpha Care Hospice, Inc)
• MTS Health Supplies Inc
• Mercy Rose Mulder I, PA-C
• Denise Munguia
• Ashley Cordero Munoz, PSYD
• Judith Munoz
• Barrett Muntiel
• Anna Marie Murguia, LMFT

• Family Nurse Practitioner in Chino, CA
• Providers in Chino, CA by specialty
• Family Nurse Practitioner in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.