Provider Demographics
NPI:1487765178
Name:MURRAY, VIRGINIA L (LCSW)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:L
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 WINDPLAY DR
Mailing Address - Street 2:BLD 3, OFFICE 201
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9365
Mailing Address - Country:US
Mailing Address - Phone:916-844-8160
Mailing Address - Fax:
Practice Address - Street 1:5000 WINDPLAY DR
Practice Address - Street 2:BLD 3, OFFICE 201
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9365
Practice Address - Country:US
Practice Address - Phone:916-844-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA162461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA680323917Medicare UPIN
CAZZZ35145ZMedicare UPIN