MEDICARE: MS. KERI ANNE MURDOCK LCSW

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	1041C0700X	Clinical Social Worker	LCS 23619	CA

General Provider Information

NPI Number	:	1427195064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KERI ANNE MURDOCK LCSW

Provider Business Mailing Address
First Line	:	165 17TH ST
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-2682
Country	:	US
Telephone Number	:	831-915-5201
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 17TH ST
Second Line	:
City	:	PACIFIC GROVE
State	:	CA
Zip	:	93950-2682
Country	:	US
Telephone Number	:	831-915-5201
Fax Number	:

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	12/13/2015

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