Provider Demographics
NPI:1730302134
Name:ENOS, MURIEL LYNN (RNC,PHYD)
Entity Type:Individual
Prefix:
First Name:MURIEL
Middle Name:LYNN
Last Name:ENOS
Suffix:
Gender:F
Credentials:RNC,PHYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 REDBUD
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-1116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST STE 212
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4522
Practice Address - Country:US
Practice Address - Phone:714-834-2125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA380278163WP0808X
CAPSY20957103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral