Healthcare Provider Details

I. General information

NPI: 1023964137
Provider Name (Legal Business Name): MS. MARIAM ELISE MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 CAMINO PLZ UNIT A
SAN BRUNO CA
94066-3401
US

IV. Provider business mailing address

2543 24TH ST
SAN FRANCISCO CA
94110-3508
US

V. Phone/Fax

Practice location:
  • Phone: 415-231-5771
  • Fax:
Mailing address:
  • Phone: 949-421-9553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: