Basic Information
| Provider Information | |||||||||
| NPI: | 1871898114 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | DENISE | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2115 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950621663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314200120 | ||||||||
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| Practice Location | |||||||||
| Address1: | 126A FRONT STREET | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314279343 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2011 | ||||||||
| LastUpdateDate: | 01/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 44AV | 01 | CA | MEDI-CAL PRVNBR | OTHER |