Active NPI
Brock Tuller, LMFT
- Marriage & Family Therapist
- Fullerton, CA
National Provider Identifier
1851805626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT117211
- Practice address
- 1370 Brea Blvd Ste 132
Fullerton, CA 92835-4123 - Phone
- (559) 301-7507
- NPI assigned
- Nov 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF91276 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT117211 | CA | Primary |
Addresses
Primary practice location
1370 Brea Blvd Ste 132
Fullerton, CA 92835-4123
Mailing address
11278 Los Alamitos Blvd # 317
Los Alamitos, CA 90720-3958
Phone (559) 301-7507
Other practice location 1
8531 Golden Meadow Dr
Yucca Valley, CA 92284-4191
Phone (559) 301-7507
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF91276 | CA | MD | Marriage & Family Therapist |
| LMFT117211 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1851805626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11278 LOS ALAMITOS BLVD # 317",
"city": "LOS ALAMITOS",
"state": "CA",
"postal_code": "907203958",
"telephone_number": "559-301-7507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1370 BREA BLVD STE 132",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928354123",
"telephone_number": "559-301-7507"
}
],
"practiceLocations": [
{
"address_1": "8531 Golden Meadow Dr",
"address_purpose": "LOCATION",
"city": "Yucca Valley",
"state": "CA",
"postal_code": "922844191",
"country_code": "US",
"telephone_number": "559-301-7507",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TULLER",
"first_name": "BROCK",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-30",
"last_updated": "2023-02-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF91276",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT117211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.