Provider Demographics
NPI:1609104694
Name:MURRAY, JANINE (MFT)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4245
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92514-4245
Mailing Address - Country:US
Mailing Address - Phone:951-452-1185
Mailing Address - Fax:951-780-4406
Practice Address - Street 1:4053 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3536
Practice Address - Country:US
Practice Address - Phone:951-452-1185
Practice Address - Fax:951-780-4406
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist