Healthcare Provider Details

I. General information

NPI: 1114264033
Provider Name (Legal Business Name): MRS. BRITNEY SHEA MURILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2013
Last Update Date: 01/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 MASSACHUSETTS AVE #114
RIVERSIDE CA
92507-7039
US

IV. Provider business mailing address

1251 MASSACHUSETTS AVE #114
RIVERSIDE CA
92507-7039
US

V. Phone/Fax

Practice location:
  • Phone: 760-835-9090
  • Fax:
Mailing address:
  • Phone: 760-835-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: