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General NPI Number Information
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NPI Number | 1396029583
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Entity Type | Organization
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Legal Business Name | PACIFICA PSYCHOLOGY
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 1359 PINE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94109-4807
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Country | US
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Telephone | 415-290-6004
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Fax | 415-373-3752
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Provider Business Mailing Address
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Address Line | 1559B SLOAT BLVD #151
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1222
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Country | US
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Telephone | 415-290-6004
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Fax | 415-373-3752
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER MARY MURPHY
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Credential | PH.D.
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Telephone | 415-290-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY18403
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License Number State | CA
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