Provider Demographics
NPI:1720234933
Name:MURPHY, MEREDITH CHATTMAN (PHD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CHATTMAN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:JENEL
Other - Last Name:CHATTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2904 ROWENA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2042
Mailing Address - Country:US
Mailing Address - Phone:323-636-2466
Mailing Address - Fax:
Practice Address - Street 1:2904 ROWENA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2042
Practice Address - Country:US
Practice Address - Phone:323-636-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24473103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical