Diana M Fulmer

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PL 8178 Issued in CA

Practice address

5790 Magnolia Ave #202
Riverside, CA 92506-1874

Phone

(909) 625-7730

Fax

(909) 625-3352

NPI assigned

Oct 2, 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

Other names 1

• Diana M Corzo Other name

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, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1922191592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5790 MAGNOLIA AVE #202",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061874",
            "telephone_number": "909-625-7730",
            "fax_number": "909-625-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5790 MAGNOLIA AVE #202",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925061874",
            "telephone_number": "909-625-7730",
            "fax_number": "909-625-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULMER",
        "first_name": "DIANA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PL 8178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "CORZO",
            "middle_name": "M",
            "credential": "PSY D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Andy N. Fujimoto, MD
• Matthew Haru Fujita, DPT
• Matthew David Fukuda, MD
• Alesia Nesie Fuller
• Qynncie Alexandria Fuller, BA
• Melissa Fultz
• Catherine Funderburg
• Deborah Fung, M.D.
• Natalia Funn
• Ryanne Furst

• Psychologist in Riverside, CA
• Providers in Riverside, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.