SARA AJIFU - TULLY LCSW
NPI 1124528104
Social Worker - Clinical in Fountain Valley, CA

Q: What is Sara Ajifu - Tully's NPI number?

The NPI number for Sara Ajifu - Tully is 1124528104. It was assigned to this individual provider in the NPPES registry on February 16, 2018. The provider is also known as Sara Ajifu Lcsw.

Q: What is Sara Ajifu - Tully's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since February 16, 2018PECOS Enrolled

17100 EUCLID ST, FOUNTAIN VALLEY, CA 92708(714) 966-8171 Get Directions Write a Review

NPPES record last updated: October 25, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Sara Ajifu - Tully Lcsw NPPES

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

SARA AJIFU - TULLY LCSW (NPI 1124528104) is an individual clinical provider in Fountain Valley, California, licensed in California (80892) and active in the NPI registry since February 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124528104

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameSARA AJIFU - TULLYCredential: LCSW

Location Address17100 EUCLID STFountain Valley, CA 92708-4004

Mailing Address11170 Warner Ave Ste 206Fountain Valley, CA 92708-4014 · (714) 966-8171

Phone(714) 966-8171

Sole ProprietorNo

Enumeration DateFebruary 16, 2018

Last NPPES UpdateOctober 25, 2021

NPPES CertifiedOctober 25, 2021

✔ NPI 1124528104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in CA · 80892

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

17100 EUCLID ST, Fountain Valley, CA 92708

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Other Names 1

Former Name (1)Sara Ajifu Lcsw

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sara Ajifu - Tully Lcsw 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.

Medicare Billing Reassignment

Medicare enrollment records show Sara Ajifu - Tully reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group

11 mi

Health Maintenance Organization

1893 W MALVERN AVE
Fullerton, CA 92833

Reassigned Medicare billing, California enrollment
13,921 clinicians in this Medicare group

NPI 1336556059 (877) 608-0044

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92708 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $62.96 – $187.60

Typical copayment $0.00 (range $15.74 – $46.90)

Most-billed visit code NA

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAI PHAM PHARM D

Pharmacist