Provider Demographics
NPI:1538218904
Name:MURRAY, TODD EDWARD (PSYD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:EDWARD
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691-550 JANET WAY
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-9598
Mailing Address - Country:US
Mailing Address - Phone:530-257-0951
Mailing Address - Fax:
Practice Address - Street 1:691-550 JANET WAY
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-9598
Practice Address - Country:US
Practice Address - Phone:530-257-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20568103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical