Provider Demographics
NPI:1285857250
Name:MURPHY, KINZIE S (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KINZIE
Middle Name:S
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 COBBLE COVE LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-4309
Mailing Address - Country:US
Mailing Address - Phone:916-679-3268
Mailing Address - Fax:916-422-1628
Practice Address - Street 1:1515 K STREET
Practice Address - Street 2:4TH FLOOR MS 8100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95899-7413
Practice Address - Country:US
Practice Address - Phone:916-327-8719
Practice Address - Fax:916-327-1010
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 6561235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMS168539OtherPROVIDER NUMBER
CASP0065610Medicaid