Provider Demographics
NPI:1275714727
Name:MURRELL, WALTER W (PHD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:W
Last Name:MURRELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1023
Mailing Address - Country:US
Mailing Address - Phone:310-204-1950
Mailing Address - Fax:
Practice Address - Street 1:12301 WILSHIRE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1023
Practice Address - Country:US
Practice Address - Phone:310-204-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9861103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY098610Medicaid
CAPM0098610Medicaid
CAPM0098610Medicaid