Provider Demographics
NPI:1861801128
Name:MURPHY, KEVIN P
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:MURPHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 JONES ST
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5414
Mailing Address - Country:US
Mailing Address - Phone:707-463-0405
Mailing Address - Fax:707-313-4999
Practice Address - Street 1:410 JONES ST
Practice Address - Street 2:SUITE C-1
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5414
Practice Address - Country:US
Practice Address - Phone:707-463-0405
Practice Address - Fax:707-313-4999
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician