Active NPI
Antonette Marie Zulli, PHD
- Psychologist
- Riverside, CA
National Provider Identifier
1891868808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 10762
- Practice address
- 6117 Brockton Ave
Suite 207
Riverside, CA 92506 - Phone
- (951) 662-8184
- Fax
- (951) 276-4769
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 10762 | CA | Primary |
Addresses
Primary practice location
6117 Brockton Ave
Suite 207
Riverside, CA 92506
Mailing address
6117 Brockton Ave
Suite 207
Riverside, CA 92506
Phone (951) 662-8184
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080711000361 | CA | Practitioner - Clinical Psychologist | 4385716018 | Practice locations: Riverside, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10762 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PSY 10762 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891868808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6117 BROCKTON AVE",
"address_2": "SUITE 207",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92506",
"telephone_number": "951-662-8184",
"fax_number": "951-276-4769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6117 BROCKTON AVE",
"address_2": "SUITE 207",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92506",
"telephone_number": "951-662-8184",
"fax_number": "951-276-4769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZULLI",
"first_name": "ANTONETTE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 10762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.