Provider Demographics
NPI:1033596226
Name:MURPHY, KRISTINA
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VIA CANDELARIA
Mailing Address - Street 2:
Mailing Address - City:COTO DE CAZA
Mailing Address - State:CA
Mailing Address - Zip Code:92679-4145
Mailing Address - Country:US
Mailing Address - Phone:949-874-0611
Mailing Address - Fax:
Practice Address - Street 1:100 VIA CANDELARIA
Practice Address - Street 2:
Practice Address - City:COTO DE CAZA
Practice Address - State:CALIFORNIA
Practice Address - Zip Code:92679
Practice Address - Country:UM
Practice Address - Phone:949-874-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health