Provider Demographics
NPI:1699894717
Name:MURREN, MELISSA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:MURREN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11712 MOORPARK ST STE 207
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2164
Mailing Address - Country:US
Mailing Address - Phone:818-572-9880
Mailing Address - Fax:818-338-2192
Practice Address - Street 1:11712 MOORPARK ST STE 207
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2164
Practice Address - Country:US
Practice Address - Phone:818-572-9880
Practice Address - Fax:818-338-2192
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
CAPSY29661103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner