Healthcare Provider Details

I. General information

NPI: 1336052927
Provider Name (Legal Business Name): STEVE MURILLO-GOMEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 ALVARADO ST
HOLLISTER CA
95023-4043
US

IV. Provider business mailing address

PO BOX 1533
WATSONVILLE CA
95077-1533
US

V. Phone/Fax

Practice location:
  • Phone: 831-637-9269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number141810
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: