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RICHARD DANIEL FULLER PHD NPI 1578572947


NPI Information

NPI: 1578572947
Provider Name: RICHARD DANIEL FULLER, PHD
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual
Organization: FULLER DIAGNOSTICS, LLC

PECOS Registration: Yes

Address:
2600 DENALI ST
SUITE 450
ANCHORAGE, AK
ZIP 99503
Phone: (907) 561-0552
Get Directions

Richard Daniel Fuller, PHD is a clinical neuropsychologist in Anchorage, AK with 30 years of experience. 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. Richard Daniel Fuller, PHD NPI is 1578572947. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

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 NPI 1578572947 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 8/5/2006 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
1103TB0200XPsychologistCognitive & Behavioral441ALASKANo
2103TC0700XPsychologistClinical441ALASKANo
3103TC2200XPsychologistClinical Child & Adolescent441ALASKANo
4103TF0200XPsychologistForensic441ALASKANo
5103TA0700XPsychologistAdult Development & Aging441ALASKANo
6103T00000XPsychologist441ALASKANo
7103TM1800XPsychologistIntellectual and Developmental Disabilities441ALASKANo
8103G00000XClinical Neuropsychologist441ALASKAYes

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
1441OTHERALASKAPSYCHOLOGIST LICENSE
251478OTHERDISTRICT OF COLUMBIANATIONAL REGISTER-PSYCHOL
3160833MEDICARE PIN
4PS04411MEDICAIDALASKA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.