Active NPI
Laura Magdalen Tully, PHD
- Psychologist
- Sacramento, CA
National Provider Identifier
1912332107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10300000X
- Practice address
- 4701 X St
UC Davis Imaging Research Center
Sacramento, CA 95817-2219 - Phone
- (916) 734-7927
- NPI assigned
- Sep 6, 2013
- Last updated
- Sep 6, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 10300000X | NU | Primary |
Addresses
Primary practice location
4701 X St
UC Davis Imaging Research Center
Sacramento, CA 95817-2219
Mailing address
4701 X St
UC Davis Imaging Research Center
Sacramento, CA 95817-2219
Phone (916) 734-7927
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26962 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378425600000",
"number": "1912332107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4701 X ST",
"address_2": "UC DAVIS IMAGING RESEARCH CENTER",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172219",
"telephone_number": "916-734-7927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 X ST",
"address_2": "UC DAVIS IMAGING RESEARCH CENTER",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172219",
"telephone_number": "916-734-7927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "LAURA",
"middle_name": "MAGDALEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-06",
"last_updated": "2013-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": "10300000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.