Provider Demographics
NPI:1497970818
Name:MURCH, KATHLEEN JUDITH (MFC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:JUDITH
Last Name:MURCH
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9335 HAZARD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1222
Mailing Address - Country:US
Mailing Address - Phone:858-495-5610
Mailing Address - Fax:
Practice Address - Street 1:9335 HAZARD WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1222
Practice Address - Country:US
Practice Address - Phone:858-495-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44253106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist