Provider Demographics
NPI:1780191403
Name:MURPHY CARVAJAL, ANDREA M (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:MURPHY CARVAJAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 E EL PASO AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0247
Mailing Address - Country:US
Mailing Address - Phone:559-824-1235
Mailing Address - Fax:
Practice Address - Street 1:1702 E BULLARD AVE
Practice Address - Street 2:STE 105
Practice Address - City:FRESO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-824-1235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA244561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical