Provider Demographics
NPI:1215402516
Name:VINSON, MURIEL (AMFT, MA)
Entity Type:Individual
Prefix:
First Name:MURIEL
Middle Name:
Last Name:VINSON
Suffix:
Gender:F
Credentials:AMFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 TAYLOR BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2200
Mailing Address - Country:US
Mailing Address - Phone:925-338-8553
Mailing Address - Fax:
Practice Address - Street 1:6536 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1192
Practice Address - Country:US
Practice Address - Phone:510-496-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist