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General NPI Number Information
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NPI Number | 1851565402
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Entity Type | Individual
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Provider Name | MARY FRANCES KULLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 60 FENTON ST SUITE 5
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City | LIVERMORE
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State | CA
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Zip | 94550-4148
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Country | US
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Telephone | 925-321-0995
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Fax | 866-788-1124
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Provider Business Mailing Address
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Address Line | PO BOX 2042
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City | LIVERMORE
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State | CA
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Zip | 94551-2042
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Country | US
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Telephone | 925-321-0995
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Fax | 866-788-1124
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G65806
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | G65806
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License Number State | CA
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