Provider Demographics
NPI:1831353978
Name:MURRAY, ILEEN G (MSW)
Entity type:Individual
Prefix:MS
First Name:ILEEN
Middle Name:G
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28401 LOS ALISOS BLVD
Mailing Address - Street 2:# 7102
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5951
Mailing Address - Country:US
Mailing Address - Phone:949-837-4724
Mailing Address - Fax:
Practice Address - Street 1:9227 HAVEN AVE
Practice Address - Street 2:STE 300
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5420
Practice Address - Country:US
Practice Address - Phone:310-473-4448
Practice Address - Fax:310-477-1312
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 21848104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker