Healthcare Provider Details

I. General information

NPI: 1275980898
Provider Name (Legal Business Name): LUPE STEPHANIE MURPHY CADC-II, ICADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 N SUNRISE WAY
PALM SPRINGS CA
92262-5201
US

IV. Provider business mailing address

191 N SUNRISE WAY
PALM SPRINGS CA
92262-5201
US

V. Phone/Fax

Practice location:
  • Phone: 760-770-2286
  • Fax: 760-770-2204
Mailing address:
  • Phone: 760-770-2286
  • Fax: 760-770-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA020410815
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberA020410815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: