Healthcare Provider Details

I. General information

NPI: 1740125251
Provider Name (Legal Business Name): ALICIA MURILLO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2812 OLD WINERY PLACE SUITE 21
SACRAMENTO CA
95827
US

IV. Provider business mailing address

22375 CHITTENDEN RD
CORNING CA
96021-9738
US

V. Phone/Fax

Practice location:
  • Phone: 916-485-6711
  • Fax:
Mailing address:
  • Phone: 530-826-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: