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DR. KRISTEN MICHELE FULLER M.D.
NPI 1053654269
Student in an Organized Health Care Education/Training Program in Villa Park, CA

Active since April 05, 2013PECOS Enrolled
9461 FEATHERHILL DR, VILLA PARK, CA 92861(805) 252-6828 Get Directions Write a Review

NPPES record last updated: October 29, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kristen Michele Fuller M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KRISTEN MICHELE FULLER M.D. (NPI 1053654269) is an individual student in an organized health care education/training program in Villa Park, California and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053654269
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. KRISTEN MICHELE FULLERCredential: M.D.
Location Address9461 FEATHERHILL DRVilla Park, CA 92861-2613
Mailing Address9461 Featherhill DrVilla Park, CA 92861-2613 · (805) 252-6828
Phone(805) 252-6828
Sole ProprietorYes
Enumeration DateApril 5, 2013
Last NPPES UpdateOctober 29, 2014
✔ NPI 1053654269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
9461 FEATHERHILL DR, Villa Park, CA 92861
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kristen Michele Fuller M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristen Fuller's NPI number?

The NPI number for Kristen Fuller is 1053654269. It was assigned to this individual provider in the NPPES registry on April 5, 2013.

Where is Kristen Fuller located?

Kristen Fuller practices at 9461 Featherhill Dr, Villa Park, CA 92861. The listed phone number is (805) 252-6828.

What is Kristen Fuller's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kristen Fuller enrolled in Medicare?

Yes. Kristen Fuller is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kristen Fuller was last updated on October 29, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.