Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 14669 | CA |
NPI | 1043798820 |
---|---|
Provider Name | Maryjan Murphy |
First Address | Santa Cruz, CA 95064-1077 |
Second Address | Santa Cruz, CA 95064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2018 |
Last Update Date | 02/08/2018 |