Provider Demographics
NPI:1851565402
Name:KULLA, MARY FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:KULLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2042
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-2042
Mailing Address - Country:US
Mailing Address - Phone:925-321-0995
Mailing Address - Fax:866-788-1124
Practice Address - Street 1:60 FENTON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4148
Practice Address - Country:US
Practice Address - Phone:925-321-0995
Practice Address - Fax:866-788-1124
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG658062084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry