Pamela Meghan Tiedemann-Fuller, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY23513 Issued in CA

Practice address

3260 Beard Rd
Suite 4
Napa, CA 94558-3423

Phone

(707) 556-2356

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• North Bay Psychology

  • Clinical Psychologist
  • Napa, CA
  • NPI 1740556489
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431302400000",
    "number": "1922186949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5524",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945810524",
            "telephone_number": "707-556-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 BEARD RD",
            "address_2": "SUITE 4",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583423",
            "telephone_number": "707-556-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDEMANN-FULLER",
        "first_name": "PAMELA",
        "middle_name": "MEGHAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhianna Thoreson
• Melissa Thrash-Pena, ACSW
• Jessica Thrift, CNM, WHNP-BC
• Thrifty Payless Inc (Rite Aid Pharmacy 05928)
• Lu Tian, DDS
• Helen Tierney, M.D.
• Ryan Michael Tigrett, D.D.S.
• Kimberly Tillman, MA, CCC-SLP
• Janice R Timm, PH.D.
• Kathleen Marie Timm, RN

• Clinical Psychologist in Napa, CA
• Providers in Napa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.