Active NPI
Jacqueline Murphy
- Addiction (Substance Use Disorder) Counselor
- San Bernardino, CA
National Provider Identifier
1376753525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- RS5053
- Practice address
- 939 And 955 N D St
San Bernardino, CA 92418-0001 - Phone
- (909) 381-5100
- Fax
- (909) 381-5101
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | RS5053 | CA | Primary |
Addresses
Primary practice location
939 And 955 N D St
San Bernardino, CA 92418-0001
Mailing address
PO Box 7369
Redlands, CA 92375-0369
Phone (909) 335-7067
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5342 | Other | CA | SIMON STAFF NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RS5053 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376753525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7369",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923750369",
"telephone_number": "909-335-7067",
"fax_number": "909-792-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "939 AND 955 N D ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924180001",
"telephone_number": "909-381-5100",
"fax_number": "909-381-5101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURPHY",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "RS5053",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIMON STAFF NUMBER",
"identifier": "5342",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.