Healthcare Provider Details
I. General information
NPI: 1376878686
Provider Name (Legal Business Name): ANGELA MURRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/05/2009
Last Update Date: 07/26/2025
Certification Date: 07/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1340 ARNOLD DR STE 125
MARTINEZ CA
94553-4189
US
IV. Provider business mailing address
1340 ARNOLD DR STE 125
MARTINEZ CA
94553-4189
US
V. Phone/Fax
- Phone: 925-405-2111
- Fax:
- Phone: 925-405-2111
- Fax: 925-521-5639
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 167G00000X |
| Taxonomy | Licensed Psychiatric Technician |
| License Number | PT 32122 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Registered Nurse |
| License Number | 95168261 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: