Provider Demographics
NPI:1427893155
Name:MURILLO, JANITZY DAFNE
Entity type:Individual
Prefix:
First Name:JANITZY
Middle Name:DAFNE
Last Name:MURILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 BALBOA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6367
Mailing Address - Country:US
Mailing Address - Phone:818-798-3047
Mailing Address - Fax:818-484-3513
Practice Address - Street 1:10605 BALBOA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6367
Practice Address - Country:US
Practice Address - Phone:818-798-3047
Practice Address - Fax:818-484-3513
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1292311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1041C0700XMedicaid