Healthcare Provider Details

I. General information

NPI: 1396035606
Provider Name (Legal Business Name): LUCY TOVAR MURILLO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date: 06/03/2020
Reactivation Date: 07/14/2020

III. Provider practice location address

45111 FERN AVE
LANCASTER CA
93534-2301
US

IV. Provider business mailing address

41124 OAKVIEW LN
PALMDALE CA
93551-1155
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-1206
  • Fax: 661-940-5452
Mailing address:
  • Phone: 661-233-5712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC7431
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 006333
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: