Provider Demographics
NPI:1619008729
Name:MURACHVER, MINDY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:
Last Name:MURACHVER
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 1:12714 AVALON BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-2730
Mailing Address - Country:US
Mailing Address - Phone:323-777-0130
Mailing Address - Fax:323-777-5294
Practice Address - Street 1:12714 AVALON BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2730
Practice Address - Country:US
Practice Address - Phone:323-777-0130
Practice Address - Fax:323-777-5294
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB-32107103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical