Provider Demographics
NPI:1447423272
Name:MURPHY, PETER JOSEPH (PHD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17337 VENTURA BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3903
Mailing Address - Country:US
Mailing Address - Phone:818-990-2966
Mailing Address - Fax:818-990-9403
Practice Address - Street 1:17337 VENTURA BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3903
Practice Address - Country:US
Practice Address - Phone:818-990-2966
Practice Address - Fax:818-990-9403
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-13
Last Update Date:2008-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20411103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent