Healthcare Provider Details

I. General information

NPI: 1700989308
Provider Name (Legal Business Name): MINNETTE B. MURPHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINNETTE BLACK

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

564 29TH ST
OAKLAND CA
94609-3513
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-5270
  • Fax: 415-206-4722
Mailing address:
  • Phone: 510-451-5449
  • Fax: 510-835-3533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG48910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: