DR. KRISTI H FULLER (NPI# 1700865029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700865029 |
| Entity Type | Individual |
| Full Name | DR. KRISTI H FULLER |
| Credential | PHD, ABPP-CN |
| Practice Address |
2600 Denali St Suite 450 Anchorage AK 99503-2746 |
| Mailing Address |
Po Box 92303 Anchorage AK 99509-2303 |
| Practice Telephone | 9075610552 |
| Practice Fax Number | 9075610562 |
| Mailing Telephone | 9075610552 |
| Mailing Fax Number | 9075610562 |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2012-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 436 | AK | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | 436 | AK | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
436 | AK | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
436 | AK | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
436 | AK | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
436 | AK | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
436 | AK | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
436 | AK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | NATIONAL REGISTER-PSYCHOL | 51470 | 01 |
| AK | AETNA PIN | 5093431 | 01 |
| AK | ABPP-CN | 5905 | 01 |
| AK | PS8574 | 05 | |
| AK | STATE LICENSE | 436 | 01 |
| AK | TRIWEST | 203902391 | 01 |
| Street Address |
2600 DENALI ST SUITE 450 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99503-2746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972987386 | Karin Lee Schaff | Counselor | 2600 Denali St, Suite 302, Anchorage, AK 99503-2746 | 2015-07-15 |
| 1316375793 | Sheryl Martin | Counselor | 2600 Denali St, Suite 302, Anchorage, AK 99503-2746 | 2013-10-23 |
| 1558600031 | Melissa Mae Tourtillott | Counselor | 2600 Denali St, Suite 302, Anchorage, AK 99503-2746 | 2013-02-04 |
| 1205117975 | Nova Eyecare Center, LLC | Optometrist | 2600 Denali St, Suite 603, Anchorage, AK 99503-2746 | 2011-09-07 |
| 1194029488 | Krista Ann Pemberton | Social Worker | 2600 Denali St, Suite 450, Anchorage, AK 99503-2746 | 2010-12-31 |
| 1821392119 | Maureen Young | Social Worker | 2600 Denali St, Suite 450, Anchorage, AK 99503-2746 | 2010-12-31 |
| 1205148301 | Denali Pediatric Dentistry | Clinic/Center | 2600 Denali St, Suite 500, Anchorage, AK 99503-2746 | 2010-07-07 |
| 1790015501 | Marilyn J. Carpenter | Marriage & Family Therapist | 2600 Denali St, Suite 606, Anchorage, AK 99503-2746 | 2009-12-30 |
| 1790019628 | Harden Healthcare, LLC | Psychiatry & Neurology | 2600 Denali St, Suite 606, Anchorage, AK 99503-2746 | 2009-09-24 |
| 1780813006 | Jonathan S Weaver | Dentist | 2600 Denali St, Suite 500, Anchorage, AK 99503-2746 | 2009-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020772 | Miladis Mcduffie | Massage Therapist | 1350 W. Northern Lights Blvd, Ste C, Anchorage, AK 99503 | 2020-10-15 |
| 1447804984 | Bethany Lynn Becker | Optometrist | 401 E. Northern Lights Blvd. Suite 102, Anchorage, AK 99503 | 2019-08-01 |
| 1265084933 | Carr-gottstein Foods Co | Durable Medical Equipment & Medical Supplies | 2920 Seward Hwy, Anchorage, AK 99503 | 2019-07-12 |
| 1982268942 | Rukiyia Smith | Behavior Technician | 205 E Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-25 |
| 1245894310 | Mary Kathleen Tate | Specialist/Technologist | 205 E. Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-24 |
| 1194295766 | Kimberly Sue Trent | Registered Nurse | 670 W. Fireweed Lane Suite 160, Anchorage, AK 99503 | 2018-11-27 |
| 1659869089 | Alaska Spine & Pain Center, LLC | Chiropractor | 3901 Old Seward Hwy Ste 11, Anchorage, AK 99503 | 2018-05-01 |
| 1235643123 | Rosanne Louise Klouda | Massage Therapist | 213 Fireweed Ln, Anchorage, AK 99503 | 2017-11-30 |
| 1801309042 | Online Care Group Alaska | General Practice | 200 W. 34th Ave, Anchorage, AK 99503 | 2017-11-09 |
| 1548773849 | Leslie K Michalski | Massage Therapist | 510 W Tudor Rd Ste 9, Anchorage, AK 99503 | 2017-11-08 |
| Find all providers in zip 99503 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245542448 | Kara Stocker | Clinical Neuropsychologist | 707 A St Ste 115, Anchorage, AK 99501-3600 | 2010-07-06 |
| 1962526517 | Keith A. Youngblood | Clinical Neuropsychologist | 7331 Clairborne Dr, Anchorage, AK 99502-7119 | 2007-03-19 |
| 1477685246 | Paul L Craig | Clinical Neuropsychologist | 4048 Laurel St Ste 102, Anchorage, AK 99508-5389 | 2007-03-09 |
| 1326095837 | Russell S Cherry | Clinical Neuropsychologist | 4241 B St, Suite 202, Anchorage, AK 99503-5920 | 2006-05-28 |
| 1215587001 | Psychological Services Group, LLC | Clinical Neuropsychologist | 707 A St Ste 115, Anchorage, AK 99501-3600 | 2019-09-13 |
| 1902303563 | Psychological Services Group, LLC | Clinical Neuropsychologist | 707 A St Ste 115, Anchorage, AK 99501-3600 | 2018-04-10 |
| 1235570979 | Sandra M Mitchell | Clinical Neuropsychologist | 1100 E Dimond Blvd, Anchorage, AK 99515-2010 | 2013-07-10 |
| 1659689222 | Alaska Neuro Associates, LLC | Clinical Neuropsychologist | 4241 B St, Suite 202, Anchorage, AK 99503-5920 | 2010-09-17 |
| 1366759003 | Erica Coady | Clinical Neuropsychologist | 3760 Piper St Ste 1108, Anchorage, AK 99508-4683 | 2010-09-01 |
| 1578572947 | Richard Daniel Fuller | Clinical Neuropsychologist | 2600 Denali St, Suite 450, Anchorage, AK 99503-2746 | 2006-08-05 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.