MS. KRISTIN MARIE LULICH (NPI# 1942574967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942574967 |
| Entity Type | Individual |
| Full Name | MS. KRISTIN MARIE LULICH |
| Other Name | KRISTIN MARIE PREISER |
| Credential | MSN, PMHNP-BC |
| Practice Address |
4510 Executive Dr #115 San Diego CA 92121-3021 |
| Practice Telephone | 6193836700 |
| Mailing Telephone | 6193836700 |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2016-12-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 795367 | CA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95002702 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4510 EXECUTIVE DR #115 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-3021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538153747 | James Raymond Moitoza | Orthopaedic Surgery | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2005-09-01 |
| 1255999736 | Chelsea Vanderwoude | Student in an Organized Health Care Education/Training Program | 4510 Executive Dr, San Diego, CA 92121-3021 | 2019-05-30 |
| 1164959433 | Keri Anne O'connor | Registered Nurse | 4510 Executive Dr, San Diego, CA 92121-3021 | 2017-05-17 |
| 1891230868 | Kaizen Brain Center | Psychiatry & Neurology | 4510 Executive Dr, Suite 107, San Diego, CA 92121-3021 | 2016-12-30 |
| 1285179614 | Hatem Abou-sayed Md Mba Facs - A Professional Medical Corporation | Plastic Surgery | 4510 Executive Dr, Suite 105, San Diego, CA 92121-3021 | 2016-12-20 |
| 1508310319 | Ana Ramirez | Psychologist | 4510 Executive Dr, Suite 315, San Diego, CA 92121-3021 | 2016-08-09 |
| 1457711657 | Achieve Tms Centers, LLC | Psychiatry & Neurology | 4510 Executive Dr, 115, San Diego, CA 92121-3021 | 2016-03-01 |
| 1932501640 | K Kohani D D S A Professional Corporation | Dentist | 4510 Executive Dr, Suite 205, San Diego, CA 92121-3021 | 2014-09-24 |
| 1306263470 | Eric Lamarca | Radiologic Technologist | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2014-03-26 |
| 1902220809 | Shashita Inamdar Md Professional Corporation | Psychiatry & Neurology | 4510 Executive Dr, Ste 115, San Diego, CA 92121-3021 | 2014-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609431196 | Tanya Denise Stevenson-gaines | Nurse Practitioner | 13988 Royal Melbourne Sq, San Diego, CA 92128-3646 | 2019-05-09 |
| 1457788598 | Christopher John Reddin | Nurse Practitioner | Naval Medical Center San Diego C I D, 34800 Bob Wilson Drive, San Diego, CA 92134-0001 | 2013-10-03 |
| 1356650634 | Jamie M Sorenson | Nurse Practitioner | Center Star Act Mental Health Systems, 4283 El Cajon Blvd, Suite 115, San Diego, CA 92105-0001 | 2010-10-04 |
| 1023345204 | Nelda K. Coleman | Nurse Practitioner | 4715 Viewridge Avenue, Suite 230, San Diego, CA 92123 | 2009-11-10 |
| 1972506483 | Steven G Hogan | Nurse Practitioner | 8810 Rio San Diego Dr, San Diego, CA 92108-1698 | 2005-05-30 |
| 1396358024 | Stephanie Joyce Reed | Nurse Practitioner | 2630 1st Ave, San Diego, CA 92103-6599 | 2020-08-24 |
| 1104442185 | Joshua Don Dougherty | Nurse Practitioner | 1550 Hotel Cir N Ste 450, San Diego, CA 92108-2933 | 2020-06-24 |
| 1801422258 | Safiya Damali Daley | Nurse Practitioner | 1675 Morena Blvd, San Diego, CA 92110-3703 | 2020-03-17 |
| 1083247779 | Fernando Ebeo Serrano Jr. | Nurse Practitioner | 3491 Kurtz St Ste 150, San Diego, CA 92110-4430 | 2020-02-20 |
| 1538790605 | Kat Tupas Balingit | Nurse Practitioner | 140 Arbor Dr, San Diego, CA 92103-2007 | 2020-01-28 |
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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.