Provider Demographics
NPI:1831118322
Name:MURPHY, GRACE E (RN MFT)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:E
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RN MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 NAVAJO PL
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1169
Mailing Address - Country:US
Mailing Address - Phone:310-373-5158
Mailing Address - Fax:310-373-5158
Practice Address - Street 1:3641 NAVAJO PL
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-1169
Practice Address - Country:US
Practice Address - Phone:310-373-5158
Practice Address - Fax:310-373-5158
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT17010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist