Provider Demographics
NPI:1598965808
Name:BOSTON, MURDIS LATOYA (MA)
Entity Type:Individual
Prefix:MS
First Name:MURDIS
Middle Name:LATOYA
Last Name:BOSTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 CENTINELA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-6930
Mailing Address - Country:US
Mailing Address - Phone:323-285-0882
Mailing Address - Fax:
Practice Address - Street 1:1626 CENTINELA AVE STE 100
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-6930
Practice Address - Country:US
Practice Address - Phone:323-285-0882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT88006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist