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General NPI Number Information
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NPI Number | 1124504170
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Entity Type | Individual
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Provider Name | HIPOLITO MURILLO LEP
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Gender | Male
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 1330 S KNOTT AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-4798
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Country | US
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Telephone | 714-236-3812
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Fax | 714-828-5325
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Provider Business Mailing Address
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Address Line | 1330 S KNOTT AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-4798
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Country | US
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Telephone | 714-236-3812
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Fax | 714-828-5325
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2896
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License Number State | CA
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