Provider Demographics
NPI:1093082349
Name:MURPHY, KIM GAVOR (MFT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:GAVOR
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6244 EL CAJON BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3918
Mailing Address - Country:US
Mailing Address - Phone:619-838-9460
Mailing Address - Fax:619-303-7595
Practice Address - Street 1:7364 EL CAJON BLVD STE 212
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-1867
Practice Address - Country:US
Practice Address - Phone:619-838-9460
Practice Address - Fax:619-303-7595
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50674106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist