MEDICARE: DR. GINA MURRELL PSYD

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	103TC0700X	Clinical Psychologist	PSY22140	CA

General Provider Information

NPI Number	:	1780817296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GINA MURRELL PSYD

Provider Business Mailing Address
First Line	:	925 THE ALAMEDA
Second Line	:	STE 14
City	:	BERKELEY
State	:	CA
Zip	:	94707-2310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	925 THE ALAMEDA
Second Line	:	STE 14
City	:	BERKELEY
State	:	CA
Zip	:	94707-2310
Country	:	US
Telephone Number	:	510-205-3711
Fax Number	:

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

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	07/24/2018

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