MEDICARE: TYMOTHY M MURPHY-BERDAHL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	373H00000X	Day Training/Habilitation Specialist	CA
2	172V00000X	Community Health Worker
3	372600000X	Adult Companion

General Provider Information

NPI Number	:	1033944715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYMOTHY M MURPHY-BERDAHL

Provider Business Mailing Address
First Line	:	8243 E STOCKTON BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-8204
Country	:	US
Telephone Number	:	888-965-6647
Fax Number	:

Provider Business Practice Location Address
First Line	:	8243 E STOCKTON BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-8204
Country	:	US
Telephone Number	:	888-965-6647
Fax Number	:

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

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	11/25/2025

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