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KAITLIN OSHU-KWON FULLER MS
NPI 1922306802
Marriage & Family Therapist in Oakland, CA

Active since March 02, 2011PECOS Enrolled
5555 ASCOT DR, OAKLAND, CA 94611(510) 482-2244 Get Directions Write a Review

NPPES record last updated: November 1, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kaitlin Oshu-kwon Fuller Ms NPPES

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

KAITLIN OSHU-KWON FULLER MS (NPI 1922306802) is an individual marriage & family therapist in Oakland, California, licensed in California (95215) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922306802
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameKAITLIN OSHU-KWON FULLERCredential: MS
Location Address5555 ASCOT DROakland, CA 94611-3001
Mailing Address3800 Coolidge AveOakland, CA 94602-3311 · (510) 482-2244
Phone(510) 482-2244
Sole ProprietorNo
Enumeration DateMarch 2, 2011
Last NPPES UpdateNovember 1, 2016
✔ NPI 1922306802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 95215
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
5555 ASCOT DR, Oakland, CA 94611
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaitlin Oshu-kwon Fuller Ms 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 Kaitlin Fuller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cyti Health PC
453 mi
Mental Health (Including Community Mental Health Center)
402 W BROADWAY STE 400
San Diego, CA 92101
  • Reassigned Medicare billing, California enrollment
  • 545 clinicians in this Medicare group
NPI 1679172290 (866) 478-3978

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

Other Providers at the Same Location NPPES 6

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

MATTHEW ADAMS ROBERTSON
Behavior Technician
5555 ASCOT DR
OAKLAND, CA 94611
Alameda County (510) 879-3211
NICOLAS RAMOS
Counselor (School)
5555 ASCOT DR
OAKLAND, CA 94611
Alameda County (510) 879-3211
FRED FINCH YOUTH CENTER
Social Worker (Clinical)
5555 ASCOT DR
OAKLAND, CA 94611
Alameda County (510) 879-2110
ERICA SAEPHAN
Counselor (School)
5555 ASCOT DR
OAKLAND, CA 94611
Alameda County (510) 879-3211
DR. CHRISTINA CHEN PSYD.
Psychologist (School)
5555 ASCOT DR
OAKLAND, CA 94611
Alameda County (657) 203-1552
SAMANTHA CHRISTINA WATTS
Social Worker
5555 ASCOT DR
OAKLAND, CA 94611
Alameda County (443) 955-1518

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 Kaitlin Fuller's NPI number?

The NPI number for Kaitlin Fuller is 1922306802. It was assigned to this individual provider in the NPPES registry on March 2, 2011.

Where is Kaitlin Fuller located?

Kaitlin Fuller practices at 5555 Ascot Dr, Oakland, CA 94611. The listed phone number is (510) 482-2244.

What is Kaitlin Fuller's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Kaitlin Fuller enrolled in Medicare?

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

Which organization bills Medicare for Kaitlin Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaitlin Fuller reassigns Medicare benefits to Cyti Health PC (San Diego, CA). The 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 Kaitlin Fuller'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 Kaitlin Fuller was last updated on November 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.