Provider Demographics
NPI:1245365113
Name:MURGA, JOSE DANIEL (MFTI 42287)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:DANIEL
Last Name:MURGA
Suffix:
Gender:M
Credentials:MFTI 42287
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 N ORCUTT DR
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2713
Mailing Address - Country:US
Mailing Address - Phone:323-887-1983
Mailing Address - Fax:323-887-1983
Practice Address - Street 1:1160 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-5000
Practice Address - Country:US
Practice Address - Phone:626-335-5980
Practice Address - Fax:626-335-5989
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58450225400000X, 106H00000X
CAIMF58450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist