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FULLER DIAGNOSTICS LLC NPI 1326152711


NPI Information

NPI: 1326152711
Provider Name: FULLER DIAGNOSTICS, LLC
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
2600 DENALI ST
SUITE 450
ANCHORAGE, AK
ZIP 99503
Phone: (907) 561-0552
Get Directions

FULLER DIAGNOSTICS, LLC is a clinical neuropsychologist in Anchorage, AK. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. FULLER DIAGNOSTICS, LLC NPI is 1326152711. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2600 DENALI ST
SUITE 450
ANCHORAGE, AK
ZIP 99503-746
Phone: (907) 561-0552
Fax: (907) 561-0562

The provider's authorized official is Kristi H Fuller .
The authorized official title is Owner/partner and has the following contact phone number (907) 561-0552.

The enumeration date for this NPI number is 8/19/2006 and was last updated on 3/22/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical1022ALASKANo
21041C0700XSocial WorkerClinical1023ALASKANo
3103TB0200XPsychologistCognitive & BehavioralNo
4103TC0700XPsychologistClinicalNo
5103TC2200XPsychologistClinical Child & AdolescentNo
6103TF0200XPsychologistForensicNo
7103TM1800XPsychologistIntellectual and Developmental DisabilitiesNo
8103T00000XPsychologistNo
9103TP2701XPsychologistGroup PsychotherapyNo
10103G00000XClinical NeuropsychologistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11821392119OTHERNPI MAUREEN YOUNG LCSW
2441OTHERALASKASTATE LICENSE RICHARD FULLER
31700865029OTHERALASKANPI KRISTI FULLER
41022OTHERALASKASTATE LICENSE MAUREEN YOUNG
51578572947OTHERALASKANPI RICHARD FULLER
6PS04411MEDICAIDALASKA
71023OTHERALASKASTATE LICENSE KRISTA PEMBERTON
851470OTHERALASKANATNL REG-KRISTI FULLER
9436OTHERALASKASTATE LICENSE KRISTI FULLER
10160833MEDICARE PIN
1151478OTHERALASKANATNL REG-RICHARD FULLER
12163672MEDICARE PIN
13160671MEDICARE ID-TYPE UNSPECIFIEDALASKAGROUP MEDICARE NUMBER
141194029488OTHERNPI KRISTA PEMBERTON LCSW
15160672MEDICARE ID-TYPE UNSPECIFIEDALASKAINDIVIDUAL KRISTI FULLER
16PS8574MEDICAIDALASKA
17PSG123MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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