Individual
DR. KRISTI H FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ABPP-CN
Contact information
Practice address
2600 DENALI ST, SUITE 450, ANCHORAGE, AK 99503-2746
(907) 561-0552
(907) 561-0562
Mailing address
PO BOX 92303, ANCHORAGE, AK 99509-2303
(907) 561-0552
(907) 561-0562
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
436
AK
103T00000X
Psychologist
436
AK
103TA0700X
Adult Development & Aging Psychologist
436
AK
103TB0200X
Cognitive & Behavioral Psychologist
436
AK
103TC0700X
Clinical Psychologist
436
AK
103TC2200X
Clinical Child & Adolescent Psychologist
436
AK
103TF0200X
Forensic Psychologist
436
AK
103TM1800X
Intellectual & Developmental Disabilities Psychologist
436
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203902391
TRIWEST
AK
01
—
436
STATE LICENSE
AK
01
—
5093431
AETNA PIN
AK
01
—
51470
NATIONAL REGISTER-PSYCHOL
DC
01
—
5905
ABPP-CN
AK
05
—
PS8574
—
AK
Enumeration date
01/13/2006
Last updated
03/22/2012
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