Provider Demographics
NPI:1174837447
Name:WRENN, JOANNE MURPHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:MURPHY
Last Name:WRENN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14502 STETSON RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-9706
Mailing Address - Country:US
Mailing Address - Phone:408-257-2874
Mailing Address - Fax:
Practice Address - Street 1:14502 STETSON RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95033-9706
Practice Address - Country:US
Practice Address - Phone:408-257-2874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22649103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADM372ZMedicare PIN