Provider Demographics
NPI:1639267321
Name:MURRAY, KRYSTYNA MICHELLE
Entity Type:Individual
Prefix:MS
First Name:KRYSTYNA
Middle Name:MICHELLE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRYSTYNA
Other - Middle Name:MICHELLE
Other - Last Name:KINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1107 W MEMORY LN
Mailing Address - Street 2:10B
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-1500
Mailing Address - Country:US
Mailing Address - Phone:949-351-2177
Mailing Address - Fax:
Practice Address - Street 1:89 SAN MARINO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-0203
Practice Address - Country:US
Practice Address - Phone:949-351-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health