Healthcare Provider Details

I. General information

NPI: 1265367403
Provider Name (Legal Business Name): JESSICA MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 HUTCHINS AVE
SEBASTOPOL CA
95472-4519
US

IV. Provider business mailing address

912 CHERRY ST
SANTA ROSA CA
95404-4209
US

V. Phone/Fax

Practice location:
  • Phone: 707-738-5037
  • Fax: 707-738-5037
Mailing address:
  • Phone: 707-738-5037
  • Fax: 707-738-5037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: