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NPI Code Detail

MEDICARE: LYNN MARIE THULL

MEDICARE: LYNN MARIE THULL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY14643CA

General Provider Information

NPI Number : 1851456651
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN MARIE THULL
Provider Business Mailing Address
First Line : PO BOX 1726
Second Line :
City : YUBA CITY
State : CA
Zip : 95992-1726
Country : US
Telephone Number : 916-482-2370
Fax Number :
Provider Business Practice Location Address
First Line : 3555 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2005
Country : US
Telephone Number : 916-482-2370
Fax Number : 916-482-0635
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 07/08/2007

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