Healthcare Provider Details

I. General information

NPI: 1366570988
Provider Name (Legal Business Name): MURIEL ELIZABETH PARKER MFCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 ATCHISON ST
PASADENA CA
91104-2314
US

IV. Provider business mailing address

1245 W CIENEGA AVE SPACE 28
SAN DIMAS CA
91773-2855
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-0915
  • Fax:
Mailing address:
  • Phone: 909-394-5995
  • Fax: 909-394-5995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC24774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: