Individual provider Active NPI

Brock Tuller, LMFT

  • Marriage & Family Therapist
  • Fullerton, CA
National Provider Identifier
1851805626
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT117211 Issued in CA
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

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
IMF91276CAMDMarriage & Family Therapist
LMFT117211CAMDMarriage & 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.

Verify at the official NPI Registry.