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General NPI Number Information
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NPI Number | 1285100925
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Entity Type | Individual
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Provider Name | PATRICK DAVEY TULLY MA, LMFT
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Gender | Male
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Dates
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Enumeration Date | 10/21/2018
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 3685 MOTOR AVE STE 220
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City | LOS ANGELES
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State | CA
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Zip | 90034-5746
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Country | US
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Telephone | 323-819-0747
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Fax |
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Provider Business Mailing Address
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Address Line | 10866 WASHINGTON BLVD # 1329
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City | CULVER CITY
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State | CA
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Zip | 90232-3610
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Country | US
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Telephone | 323-819-0747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 115115
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | TPMF163
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 205051
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License Number State | TX
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