Healthcare Provider Details

I. General information

NPI: 1770917650
Provider Name (Legal Business Name): MONICA JOYCE MURPHY RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 47TH AVE
SAN FRANCISCO CA
94122-1114
US

IV. Provider business mailing address

1311 47TH AVE
SAN FRANCISCO CA
94122-1114
US

V. Phone/Fax

Practice location:
  • Phone: 415-731-5096
  • Fax:
Mailing address:
  • Phone: 415-731-5096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number513949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: