Provider Demographics
NPI:1396009841
Name:MURR, MELISSA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:M
Last Name:MURR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 FAWN GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3965
Mailing Address - Country:US
Mailing Address - Phone:707-761-0011
Mailing Address - Fax:
Practice Address - Street 1:1712 FAWN GLEN CIR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3965
Practice Address - Country:US
Practice Address - Phone:707-761-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF66320101YM0800X
CAPSY31439103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health