MEDICARE: MRS. PATTI MURPHY J.D., QMHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1023495934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATTI MURPHY J.D., QMHA

Provider Business Mailing Address
First Line	:	PO BOX 730
Second Line	:
City	:	SILETZ
State	:	OR
Zip	:	97380-0730
Country	:	US
Telephone Number	:	541-444-2014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 CARNEGIE AVE
Second Line	:	SUITE 1C
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5504
Country	:	US
Telephone Number	:	541-272-7128
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	08/16/2016

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