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General NPI Number Information
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NPI Number | 1235261876
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Entity Type | Individual
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Provider Name | ERIC C MURILLO ANGELO LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 185 E JEFFERSON AVE
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City | POMONA
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State | CA
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Zip | 91767-3815
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Country | US
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Telephone | 909-629-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 185 E JEFFERSON AVE
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City | POMONA
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State | CA
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Zip | 91767-3815
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Country | US
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Telephone |
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW18478
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27485
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License Number State | CA
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