Provider Demographics
NPI:1528242997
Name:MURPHY, COLLEEN (LSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 ORANGE TREE LN
Mailing Address - Street 2:STE 250
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4582
Mailing Address - Country:US
Mailing Address - Phone:909-307-1204
Mailing Address - Fax:909-335-3588
Practice Address - Street 1:14060 PINE ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-4618
Practice Address - Country:US
Practice Address - Phone:775-253-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical