Provider Demographics
NPI:1891872438
Name:MURPHY, STEPHANIE KRISTINE (PA-C, ATC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:KRISTINE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:KRISTINE
Other - Last Name:WICHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22431 ANTONIO PKWY # B160-613
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2804
Mailing Address - Country:US
Mailing Address - Phone:833-477-2677
Mailing Address - Fax:833-477-2677
Practice Address - Street 1:27700 MEDICAL CENTER RD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6426
Practice Address - Country:US
Practice Address - Phone:877-468-2211
Practice Address - Fax:877-868-4888
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0600022912255A2300X
CAPA53426363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer