DR. TRAVIS DAUNTIA FULTZ PSYD
NPI 1831171388
Psychologist in Chino, CA

Active since November 18, 2005PECOS EnrolledAccepts Medicare Assignment
13193 CENTRAL AVENUE, SUITE 200, CHINO, CA 91710(909) 902-9111(909) 902-9199 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Travis Dauntia Fultz Psyd NPPES

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

DR. TRAVIS DAUNTIA FULTZ PSYD (NPI 1831171388) is an individual psychologist in Chino, California, licensed in California (PSY 19419) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1831171388
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. TRAVIS DAUNTIA FULTZCredential: PSYD
Location Address13193 CENTRAL AVENUE, SUITE 200Chino, CA 91710
Mailing Address13193 Central Avenue, Suite 200Chino, CA 91710 · (909) 902-9111 · Fax (909) 902-9199
Fax(909) 902-9199
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateNovember 18, 2005
Last NPPES UpdateJuly 8, 2007
✔ NPI 1831171388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · PSY 19419
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
13193 CENTRAL AVENUE, Chino, CA 91710

Other Identifiers 2

MedicaidPSY 194190CA
Medicare ID-Type UnspecifiedOPL194190CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Travis Dauntia Fultz Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486621596
PECOS Enrollment IDI20040916000550
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 Reassignments

3

Medicare enrollment records show Travis Fultz reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community Health
5050 SAN BERNARDINO ST
Montclair, CA 91763
  • Reassigned Medicare billing, California enrollment
  • 26 clinicians in this Medicare group
Psychologist
954 W FOOTHILL BLVD STE A
Upland, CA 91786
  • Reassigned Medicare billing, California enrollment
  • 76 clinicians in this Medicare group
Primary Care
513 E LIME AVE, SUITE 103
Monrovia, CA 91016
  • Reassigned Medicare billing, California enrollment
  • 146 clinicians in this Medicare group

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
140 services34 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
43 services43 patients

Other Providers at the Same Location NPPES 4

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

Physician Assistant (Medical)
13193 CENTRAL AVENUE, SUITE 200
CHINO, CA 91710
Psychologist
13193 CENTRAL AVENUE, SUITE 200
CHINO, CA 91710
Marriage & Family Therapist
13193 CENTRAL AVENUE, SUITE 200
CHINO, CA 91710
Social Worker (Clinical)
13193 CENTRAL AVENUE, SUITE 200
CHINO, CA 91710

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 Travis Fultz's NPI number?

The NPI number for Travis Fultz is 1831171388. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Where is Travis Fultz located?

Travis Fultz practices at 13193 Central Avenue Suite 200, Chino, CA 91710. The listed phone number is (909) 902-9111.

What is Travis Fultz's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Travis Fultz enrolled in Medicare?

Yes. Travis Fultz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Travis Fultz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Travis Fultz reassigns Medicare benefits to 3 organizations: One Health Center, Inc. (Montclair, CA), Foothills Psychological Services, Inc. (Upland, CA) and Mission City Community Network, Inc. (Monrovia, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Travis Fultz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Travis Fultz was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.