Healthcare Provider Details

I. General information

NPI: 1053220160
Provider Name (Legal Business Name): ELISABETH ASHLEY MURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN ELIJO RD S STE 104
SAN MARCOS CA
92078-2048
US

IV. Provider business mailing address

1430 TAFT ST
ESCONDIDO CA
92026-2739
US

V. Phone/Fax

Practice location:
  • Phone: 228-233-7257
  • Fax:
Mailing address:
  • Phone: 228-233-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95041257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: