Provider Demographics
NPI:1922152313
Name:MURPHY, MAUREEN (DC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 GRAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4788
Mailing Address - Country:US
Mailing Address - Phone:510-419-0776
Mailing Address - Fax:510-663-2903
Practice Address - Street 1:290 GRAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4788
Practice Address - Country:US
Practice Address - Phone:510-419-0776
Practice Address - Fax:510-663-2903
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22094111N00000X
NYX007166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor